Provider Demographics
NPI:1629337639
Name:BARNES, TIFFANCY CHANIQUE (LPC)
Entity Type:Individual
Prefix:
First Name:TIFFANCY
Middle Name:CHANIQUE
Last Name:BARNES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 PAMELA CT
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-7427
Mailing Address - Country:US
Mailing Address - Phone:804-514-8766
Mailing Address - Fax:
Practice Address - Street 1:410 PAMELA CT
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-7427
Practice Address - Country:US
Practice Address - Phone:804-514-8766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010840101YP2500X
VA0701005153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional