Healthcare Provider Details

I. General information

NPI: 1740094762
Provider Name (Legal Business Name): TIFFANY GROVE LAMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 HADDONFIELD RD STE 100
CHERRY HILL NJ
08002-4807
US

IV. Provider business mailing address

57 HADDONFIELD RD STE 100
CHERRY HILL NJ
08002-4807
US

V. Phone/Fax

Practice location:
  • Phone: 609-889-8100
  • Fax:
Mailing address:
  • Phone: 717-406-5878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: