Provider Demographics
NPI:1184011488
Name:TELESCA, TIFFANY (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:
Last Name:TELESCA
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2464
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:TX
Mailing Address - Zip Code:79831-2464
Mailing Address - Country:US
Mailing Address - Phone:432-294-4153
Mailing Address - Fax:
Practice Address - Street 1:106 N 5TH ST
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:TX
Practice Address - Zip Code:79830-4602
Practice Address - Country:US
Practice Address - Phone:432-294-4153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70289101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional