Provider Demographics
NPI:1518756501
Name:BOYER, TIFFANY ROSE (LPC, ATR-BC)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ROSE
Last Name:BOYER
Suffix:
Gender:F
Credentials:LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5312 RIDGE AVE APT 407
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-3935
Mailing Address - Country:US
Mailing Address - Phone:609-619-9314
Mailing Address - Fax:
Practice Address - Street 1:1247 S CEDAR CREST BLVD STE 107
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6347
Practice Address - Country:US
Practice Address - Phone:484-202-0751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC018373101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional