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NPI Code Detail

MEDICARE: TIFFANY LEE KAELIN LMFT

MEDICARE:   TIFFANY LEE KAELIN  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMFT00252RI
2106H00000XMarriage & Family TherapistMFT00252RI

General Provider Information

NPI Number : 1336874155
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY LEE KAELIN LMFT
Provider Business Mailing Address
First Line : 207 BROADWAY APT 201
Second Line :
City : NEWPORT
State : RI
Zip : 02840-2610
Country : US
Telephone Number : 203-751-1188
Fax Number : 401-247-8379
Provider Business Practice Location Address
First Line : 207 BROADWAY APT 201
Second Line :
City : NEWPORT
State : RI
Zip : 02840-2610
Country : US
Telephone Number : 203-751-1188
Fax Number : 401-247-8379
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2022
Last Update Date : 09/17/2024

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Directions to “ TIFFANY LEE KAELIN LMFT” Practice Location

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