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General NPI Number Information
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NPI Number | 1477992766
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Entity Type | Individual
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Provider Name | TIFFANY PRIDDY LPCC
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Gender | Female
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Dates
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Enumeration Date | 06/19/2013
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 102 WINSTON WAY
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-4990
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Country | US
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Telephone | 270-789-0034
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Fax |
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Provider Business Mailing Address
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Address Line | 404 PUBLIC SQ
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City | COLUMBIA
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State | KY
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Zip | 42728-1458
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Country | US
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Telephone | 270-634-0841
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Fax | 513-636-4283
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.1600041
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCPCC00218310
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License Number State | KY
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