Provider Demographics
NPI:1104525872
Name:DUMONT, TIFFANY (LMSW)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:DUMONT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 HARVEST HILL RD STE 230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-6424
Mailing Address - Country:US
Mailing Address - Phone:972-399-9601
Mailing Address - Fax:
Practice Address - Street 1:5440 HARVEST HILL RD STE 230
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-6424
Practice Address - Country:US
Practice Address - Phone:972-399-9601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health