Provider Demographics
NPI:1073586731
Name:HAYES, TIFFANY D (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:D
Last Name:HAYES
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:J
Other - Last Name:DUTCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LSW
Mailing Address - Street 1:287 W JOHNSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2732
Mailing Address - Country:US
Mailing Address - Phone:614-305-5102
Mailing Address - Fax:614-383-7786
Practice Address - Street 1:287 W JOHNSTOWN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-2732
Practice Address - Country:US
Practice Address - Phone:614-305-5102
Practice Address - Fax:614-383-7786
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0027957104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker