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NPI Code Detail

MEDICARE: TIFFANY HARRIS LCSW

MEDICARE: TIFFANY HARRIS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCW128394PA

General Provider Information

NPI Number : 1245502780
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY HARRIS LCSW
Provider Business Mailing Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 215-823-5233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2012
Last Update Date : 12/09/2025

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