Provider Demographics
NPI:1164760252
Name:ANSCHUTZ, TIFFANY DAWN (LCSW)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:DAWN
Last Name:ANSCHUTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7004 BEE CAVE RD.
Mailing Address - Street 2:BLD. 2, STE. 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-306-1394
Mailing Address - Fax:512-306-1603
Practice Address - Street 1:7004 BEE CAVES RD STE 2-200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5087
Practice Address - Country:US
Practice Address - Phone:512-306-1394
Practice Address - Fax:512-306-1603
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX534451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical