Provider Demographics
NPI:1558816777
Name:LOMBARDO, TIFFANY (LISW-S, LICDC-CS)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:LISW-S, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 ARUNDEL CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8469
Mailing Address - Country:US
Mailing Address - Phone:513-238-3245
Mailing Address - Fax:
Practice Address - Street 1:2534 VICTORY PKWY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2004
Practice Address - Country:US
Practice Address - Phone:513-684-7968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121029101YA0400X
OHI.1201428-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)