Provider Demographics
NPI:1891460952
Name:NAGLE, TIFFANI NICOLE (LSW)
Entity Type:Individual
Prefix:
First Name:TIFFANI
Middle Name:NICOLE
Last Name:NAGLE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:TIFFANI
Other - Middle Name:NICOLE
Other - Last Name:CRASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:518 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-2323
Mailing Address - Country:US
Mailing Address - Phone:610-823-7741
Mailing Address - Fax:
Practice Address - Street 1:450 S 5TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-2642
Practice Address - Country:US
Practice Address - Phone:610-372-5645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138467104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASW138467OtherSOCIAL WORK