Provider Demographics
NPI:1598016032
Name:AKEO, TIFFANY L (LLMSW)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:L
Last Name:AKEO
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7316 KING RD
Mailing Address - Street 2:
Mailing Address - City:SPRING ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49283-9774
Mailing Address - Country:US
Mailing Address - Phone:517-795-7559
Mailing Address - Fax:
Practice Address - Street 1:25 CARE DR
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-5054
Practice Address - Country:US
Practice Address - Phone:517-439-2628
Practice Address - Fax:517-437-0110
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010948571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical