=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306753058
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TIFFANY MCLAIN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2026
-----------------------------------------------------
Last Update Date | 08/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 809 EASTERN SHORE DR
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21804-5934
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-300-6184
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 831 PARKWAY ST
-----------------------------------------------------
City | CAMBRIDGE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21613-2649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-866-5296
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 34994
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------