=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942855143
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TIFFANIE A WHELAN LPC LCADC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2019
-----------------------------------------------------
Last Update Date | 03/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 HANOVER RD SUITE 120
-----------------------------------------------------
City | FLORHAM PARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07932-1400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-508-7813
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1077
-----------------------------------------------------
City | OAKHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07755-2077
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 37AC00475800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------