Healthcare Provider Details

I. General information

NPI: 1497499008
Provider Name (Legal Business Name): TIFFANY POMMIER LAC, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 UPTOWN BLVD STE 2000
CEDAR HILL TX
75104-3528
US

IV. Provider business mailing address

1980 N HIGHWAY 77 STE 140-729
WAXAHACHIE TX
75165-7927
US

V. Phone/Fax

Practice location:
  • Phone: 318-267-2663
  • Fax:
Mailing address:
  • Phone: 318-267-2663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number102264
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPLC10273
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLAC-5175
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: