Provider Demographics
NPI:1952092652
Name:TREASTER, TIFFINI (LLPC)
Entity Type:Individual
Prefix:
First Name:TIFFINI
Middle Name:
Last Name:TREASTER
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15370 LEVAN RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1903
Mailing Address - Country:US
Mailing Address - Phone:734-737-1266
Mailing Address - Fax:
Practice Address - Street 1:15370 LEVAN RD STE 2A
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1903
Practice Address - Country:US
Practice Address - Phone:734-953-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022848101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health