Provider Demographics
NPI:1568911030
Name:CASTLEMAN, TIFFANY L (LPC, EDD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:L
Last Name:CASTLEMAN
Suffix:
Gender:F
Credentials:LPC, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39650 US HIGHWAY 19 N APT 1012
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-3952
Mailing Address - Country:US
Mailing Address - Phone:816-799-8236
Mailing Address - Fax:
Practice Address - Street 1:501 S LINCOLN AVE STE 24
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5964
Practice Address - Country:US
Practice Address - Phone:727-382-3452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2564101YM0800X
MO2011017577101YM0800X
ORC6322101YM0800X
FLMH19187101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health