Provider Demographics
NPI:1215534912
Name:MICHALAK, TIFFANY J (LCPC)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:J
Last Name:MICHALAK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 ENGLISH ROWS AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5107
Mailing Address - Country:US
Mailing Address - Phone:888-428-7890
Mailing Address - Fax:877-428-7891
Practice Address - Street 1:180 W PARK AVE STE 150
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-3348
Practice Address - Country:US
Practice Address - Phone:888-428-7890
Practice Address - Fax:877-428-7891
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180015884101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional