Healthcare Provider Details

I. General information

NPI: 1578481305
Provider Name (Legal Business Name): KELSEY TIFFANY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 OLD ROUTE 6
CARMEL NY
10512-2134
US

IV. Provider business mailing address

4 TUDOR CIR
YORKTOWN HEIGHTS NY
10598-1033
US

V. Phone/Fax

Practice location:
  • Phone: 845-835-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number3210976
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: