Provider Demographics
NPI:1265920219
Name:PERRY, TIFFANY (LPC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:PERRY
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 1:2200 MARKET ST STE 600
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-1532
Mailing Address - Country:US
Mailing Address - Phone:409-938-4814
Mailing Address - Fax:409-938-4849
Practice Address - Street 1:2200 MARKET ST STE 600
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-1532
Practice Address - Country:US
Practice Address - Phone:409-938-4814
Practice Address - Fax:409-938-4849
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health