Provider Demographics
NPI:1881130292
Name:PRICE, TIFFANY (LPC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:BRZOZKIEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3300 S MARKET ST #118
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758
Mailing Address - Country:US
Mailing Address - Phone:479-750-2020
Mailing Address - Fax:479-750-4843
Practice Address - Street 1:3300 S MARKET ST #118
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758
Practice Address - Country:US
Practice Address - Phone:479-750-2020
Practice Address - Fax:479-750-4843
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ARP1911131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health