Provider Demographics
NPI:1255876850
Name:SCHALL, TIFFANY (LPC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:SCHALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5816 EASTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6792
Mailing Address - Country:US
Mailing Address - Phone:989-244-1888
Mailing Address - Fax:989-321-6544
Practice Address - Street 1:5816 EASTMAN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6792
Practice Address - Country:US
Practice Address - Phone:989-244-1888
Practice Address - Fax:989-321-6544
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
6401018342101YP2500X
MI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional