Provider Demographics
NPI:1801170865
Name:VINYARD, CAROLINE TIFFANY (LMHC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:TIFFANY
Last Name:VINYARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8635 SE ALABAMA PL
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-4301
Mailing Address - Country:US
Mailing Address - Phone:772-713-0658
Mailing Address - Fax:
Practice Address - Street 1:2051 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-7004
Practice Address - Country:US
Practice Address - Phone:561-683-4778
Practice Address - Fax:561-683-9995
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health