Healthcare Provider Details

I. General information

NPI: 1306753058
Provider Name (Legal Business Name): TIFFANY MCLAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 EASTERN SHORE DR
SALISBURY MD
21804-5934
US

IV. Provider business mailing address

831 PARKWAY ST
CAMBRIDGE MD
21613-2649
US

V. Phone/Fax

Practice location:
  • Phone: 443-300-6184
  • Fax:
Mailing address:
  • Phone: 443-866-5296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34994
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: