Provider Demographics
NPI:1437213741
Name:WARNER, TIFFANY RAE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:RAE
Last Name:WARNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 RIVERFRONT PKWY
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-1609
Mailing Address - Country:US
Mailing Address - Phone:423-504-1911
Mailing Address - Fax:423-933-2943
Practice Address - Street 1:555 RIVERFRONT PKWY
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-1609
Practice Address - Country:US
Practice Address - Phone:423-504-1911
Practice Address - Fax:423-933-2943
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN58841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00886498AMedicaid