Provider Demographics
NPI:1417499856
Name:HOHWIELER EVANS, TIFFANY (MS, LIMHP)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:
Last Name:HOHWIELER EVANS
Suffix:
Gender:F
Credentials:MS, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 S 138TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2913
Mailing Address - Country:US
Mailing Address - Phone:402-895-4000
Mailing Address - Fax:866-895-8245
Practice Address - Street 1:3103 N 185TH ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-7124
Practice Address - Country:US
Practice Address - Phone:402-212-4836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2075101YM0800X
NE2333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE$$$$$$$$$19Medicaid