Healthcare Provider Details

I. General information

NPI: 1306708912
Provider Name (Legal Business Name): TIFFANY VERNE TINCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TIFFANY TINCH, 1300 MERCANTILE LANE 198
BOWIE MD
20721
US

IV. Provider business mailing address

1300 MERCANTILE LN
LARGO MD
20774-5327
US

V. Phone/Fax

Practice location:
  • Phone: 301-386-2991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11587
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: