Provider Demographics
NPI:1952932519
Name:CHIN, TIFFANY (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:
Last Name:CHIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BAKER AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45217-1224
Mailing Address - Country:US
Mailing Address - Phone:513-919-3896
Mailing Address - Fax:
Practice Address - Street 1:10945 REED HARTMAN HWY STE 302
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2852
Practice Address - Country:US
Practice Address - Phone:513-400-5899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1901991101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health