Provider Demographics
NPI:1184382376
Name:CRISPIN, TIFFANY
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:CRISPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2101 SIXTH AVE N
Mailing Address - Street 2:
Mailing Address - City:BIRMMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203
Mailing Address - Country:US
Mailing Address - Phone:205-502-7732
Mailing Address - Fax:
Practice Address - Street 1:2101 SIXTH AVE N
Practice Address - Street 2:
Practice Address - City:BIRMMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203
Practice Address - Country:US
Practice Address - Phone:205-635-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-04
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC05346101Y00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health