Provider Demographics
NPI:1598119513
Name:DUNEGHY, TIFFANY JACKSON (LLPC)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:JACKSON
Last Name:DUNEGHY
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38855 HILLS TECH DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3428
Mailing Address - Country:US
Mailing Address - Phone:248-871-1462
Mailing Address - Fax:248-994-4654
Practice Address - Street 1:38855 HILLS TECH DR STE 200
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3428
Practice Address - Country:US
Practice Address - Phone:248-871-1462
Practice Address - Fax:248-994-4654
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015314101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health