Provider Demographics
NPI:1477870731
Name:NEUMAN, TIFFANY (LCPC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 TERNING DR W
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-9541
Mailing Address - Country:US
Mailing Address - Phone:406-882-4655
Mailing Address - Fax:
Practice Address - Street 1:308 DEWEY AVE STE D
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9045
Practice Address - Country:US
Practice Address - Phone:406-291-1886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1489101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1477745370Medicaid