Provider Demographics
NPI:1184962912
Name:ADAMS, TIFFANY RENE (LCSW-C)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:RENE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 E LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-1731
Mailing Address - Country:US
Mailing Address - Phone:104-550-0019
Mailing Address - Fax:410-550-1748
Practice Address - Street 1:5500 E LOMBARD ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-1731
Practice Address - Country:US
Practice Address - Phone:104-550-0019
Practice Address - Fax:410-550-1748
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD175961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical