Provider Demographics
NPI:1740611599
Name:JONES-ROUSE, TIFFANY M (LCSW-C, CSC-AD)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:M
Last Name:JONES-ROUSE
Suffix:
Gender:F
Credentials:LCSW-C, CSC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 BAY DALE DR STE 211
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2815
Mailing Address - Country:US
Mailing Address - Phone:443-860-1986
Mailing Address - Fax:
Practice Address - Street 1:1298 BAY DALE DR STE 211
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2815
Practice Address - Country:US
Practice Address - Phone:443-860-1986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC1741101YA0400X
101YM0800X, 106H00000X
MD170371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist