Healthcare Provider Details

I. General information

NPI: 1821900762
Provider Name (Legal Business Name): TIFFANY LEMLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W SUPERIOR ST STE 200
DULUTH MN
55802-1939
US

IV. Provider business mailing address

222 W SUPERIOR ST STE 200
DULUTH MN
55802-1939
US

V. Phone/Fax

Practice location:
  • Phone: 218-606-1100
  • Fax: 218-520-1799
Mailing address:
  • Phone: 218-606-1100
  • Fax: 218-520-1799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number31710
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: