Provider Demographics
NPI:1073223350
Name:MATTHEWS, TIFFANY NICOLE (BCPA, BSW)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:NICOLE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:BCPA, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 TOWNSHIP LINE RD APT A8
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2270
Mailing Address - Country:US
Mailing Address - Phone:267-626-3957
Mailing Address - Fax:
Practice Address - Street 1:26 TOWNSHIP LINE RD APT A8
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2270
Practice Address - Country:US
Practice Address - Phone:267-626-3957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171400000XOther Service ProvidersHealth & Wellness Coach