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General NPI Number Information
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NPI Number | 1699532754
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Entity Type | Organization
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Legal Business Name | MAHOGANY COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 2407 PORTSMOUTH AVE
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City | TOLEDO
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State | OH
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Zip | 43613-4420
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Country | US
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Telephone | 419-215-1151
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Fax |
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Provider Business Mailing Address
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Address Line | 2407 PORTSMOUTH AVE
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City | TOLEDO
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State | OH
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Zip | 43613-4420
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIFFANY HAIRSTON
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Credential | LPCCS, LICDCCS
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Telephone | 419-215-1151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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