Provider Demographics
NPI:1609010982
Name:CARPENTER, TIFFANY KAYE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:KAYE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TIFFANY
Other - Middle Name:KAYE
Other - Last Name:CAROTHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:4200 RIDGECREST CIR STE A-6
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5416
Mailing Address - Country:US
Mailing Address - Phone:806-282-5106
Mailing Address - Fax:888-393-2231
Practice Address - Street 1:6010 W AMARILLO BLVD
Practice Address - Street 2:BLDG 45
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1990
Practice Address - Country:US
Practice Address - Phone:806-355-9703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50518-1707741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical