Healthcare Provider Details

I. General information

NPI: 1831739291
Provider Name (Legal Business Name): TIFFANY MCCAUGHEY, PHD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2223 QUAIL RUN STE H1
BATON ROUGE LA
70808-9063
US

IV. Provider business mailing address

4545 WHITEHAVEN ST
BATON ROUGE LA
70808-3875
US

V. Phone/Fax

Practice location:
  • Phone: 225-366-8098
  • Fax:
Mailing address:
  • Phone: 504-495-5559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TIFFANY MCCAUGHEY
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 504-495-5559