Provider Demographics
NPI:1912337858
Name:CROOKS, TIFFANY AMANDA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:AMANDA
Last Name:CROOKS
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 1:50 ROCKY CREEK RD APT 129
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6172
Mailing Address - Country:US
Mailing Address - Phone:864-551-5193
Mailing Address - Fax:
Practice Address - Street 1:1400 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2410
Practice Address - Country:US
Practice Address - Phone:864-608-7985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)