Provider Demographics
NPI:1275866154
Name:TRAVERS, TIFFANY L (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:L
Last Name:TRAVERS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MRS
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:TRAVERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:100 E CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5422
Mailing Address - Country:US
Mailing Address - Phone:410-546-6400
Mailing Address - Fax:
Practice Address - Street 1:100 E CARROLL ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5422
Practice Address - Country:US
Practice Address - Phone:410-546-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14226104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD068375200Medicaid
MD119591300Medicaid
MDS118Medicare PIN
211833Medicare Oscar/Certification