Provider Demographics
NPI:1356896153
Name:ENGLISH, TIFFANY CLORICE (LCAS, LCMHC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:CLORICE
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:LCAS, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 SEVEN MILE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-8509
Mailing Address - Country:US
Mailing Address - Phone:828-675-4116
Mailing Address - Fax:828-675-9312
Practice Address - Street 1:116 SEVEN MILE RIDGE RD
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-8509
Practice Address - Country:US
Practice Address - Phone:828-675-4116
Practice Address - Fax:828-675-9312
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-22
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-25080101YA0400X
NCA12426101YM0800X
NC12426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1356896153Medicaid