Healthcare Provider Details

I. General information

NPI: 1013400639
Provider Name (Legal Business Name): TIFFANEY MILLS MSW, LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2018
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17904 GEORGIA AVE STE 200
OLNEY MD
20832-2277
US

IV. Provider business mailing address

3532 PEAR TREE CT # 12
SILVER SPRING MD
20906-2566
US

V. Phone/Fax

Practice location:
  • Phone: 240-304-3327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21027
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: