Provider Demographics
NPI:1457658296
Name:AMERSON, TIFFANY S (LPC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:S
Last Name:AMERSON
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 1:513 BROOKSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2545
Mailing Address - Country:US
Mailing Address - Phone:214-477-1306
Mailing Address - Fax:
Practice Address - Street 1:513 BROOKSHIRE LN
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2545
Practice Address - Country:US
Practice Address - Phone:214-477-1306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64615101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health