Provider Demographics
NPI:1780967810
Name:GAY, TIFFANY R (MSW)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:R
Last Name:GAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 E. RITTENHOUSE STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138
Mailing Address - Country:US
Mailing Address - Phone:610-328-2700
Mailing Address - Fax:610-328-2711
Practice Address - Street 1:1260 E WOODLAND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3969
Practice Address - Country:US
Practice Address - Phone:610-328-2700
Practice Address - Fax:610-328-2711
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker