Provider Demographics
NPI:1407278021
Name:GIANNAKOUROS, TIFFANY (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:
Last Name:GIANNAKOUROS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:SEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:36 72ND ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1856
Mailing Address - Country:US
Mailing Address - Phone:347-380-3842
Mailing Address - Fax:
Practice Address - Street 1:36 72ND ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1856
Practice Address - Country:US
Practice Address - Phone:347-380-3842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0740651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical