Provider Demographics
NPI:1629508882
Name:HUNSLEY, TIFFANY LEIGH (LSW, LADC)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:LEIGH
Last Name:HUNSLEY
Suffix:
Gender:F
Credentials:LSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 16TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-4158
Mailing Address - Country:US
Mailing Address - Phone:507-218-4773
Mailing Address - Fax:507-316-0891
Practice Address - Street 1:25 16TH ST NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-4158
Practice Address - Country:US
Practice Address - Phone:507-218-4773
Practice Address - Fax:507-316-0891
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1082019-1-CDT175T00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist