Provider Demographics
NPI:1942749932
Name:ZIEGLER, TIFFANY (MS, LPC-IT, SAC-IT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:MS, LPC-IT, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 ORIN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-3643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 W OLIN AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-2142
Practice Address - Country:US
Practice Address - Phone:608-255-2955
Practice Address - Fax:608-255-0340
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
WI1774101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1215375472Medicaid
WI1407100514Medicaid