Provider Demographics
NPI:1437730363
Name:TIFFANY KOCHER, LICSW PLLC
Entity Type:Organization
Organization Name:TIFFANY KOCHER, LICSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-505-3783
Mailing Address - Street 1:175 DERBY ST STE 4
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-4021
Mailing Address - Country:US
Mailing Address - Phone:978-505-3783
Mailing Address - Fax:617-404-3302
Practice Address - Street 1:175 DERBY ST STE 4
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4021
Practice Address - Country:US
Practice Address - Phone:978-505-3783
Practice Address - Fax:617-404-3302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)