Healthcare Provider Details

I. General information

NPI: 1255247284
Provider Name (Legal Business Name): MS. TIFFANY AUSTIN EMANUEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 ELLEN ST STE B
MONROE NC
28112-5286
US

IV. Provider business mailing address

8936 NORTHPOINTE EXECUTIVE PARK DRIVE SUITE 240/260
HUNTERSVILLE NC
28078
US

V. Phone/Fax

Practice location:
  • Phone: 980-236-9244
  • Fax: 833-450-5044
Mailing address:
  • Phone: 980-375-6712
  • Fax: 833-450-5044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: