Healthcare Provider Details

I. General information

NPI: 1962001735
Provider Name (Legal Business Name): ALLISON ELAINE TIGNOR LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2020
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S WASHINGTON ST
MARION IN
46952-3867
US

IV. Provider business mailing address

505 N WABASH AVE
MARION IN
46952-2608
US

V. Phone/Fax

Practice location:
  • Phone: 765-662-9971
  • Fax: 765-651-6556
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88002646A
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-139827
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: