Provider Demographics
NPI:1215550074
Name:GUY, TIFFANY (LMFT ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:GUY
Suffix:
Gender:F
Credentials:LMFT ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 SPRINGHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-1629
Mailing Address - Country:US
Mailing Address - Phone:704-665-0423
Mailing Address - Fax:
Practice Address - Street 1:4219 SPRINGHAVEN DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1629
Practice Address - Country:US
Practice Address - Phone:704-665-0423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12172A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist