Provider Demographics
NPI:1891442752
Name:TAYLOR-JENKINS, TIFFANI LYNN (LGSW)
Entity Type:Individual
Prefix:
First Name:TIFFANI
Middle Name:LYNN
Last Name:TAYLOR-JENKINS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 PENNSYLVANIA AVE SE # 415
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4303
Mailing Address - Country:US
Mailing Address - Phone:732-964-5350
Mailing Address - Fax:
Practice Address - Street 1:1629 K ST
Practice Address - Street 2:SUITE 300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006
Practice Address - Country:US
Practice Address - Phone:732-964-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50083248104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker