MEDICARE: TIFFANY ST JOHN VOINCHE

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
1	101Y00000X	Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YP2500X	Professional Counselor
4	171M00000X	Case Manager/Care Coordinator
5	101YP2500X	Professional Counselor	9044	LA

General Provider Information

NPI Number	:	1255966636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY ST JOHN VOINCHE

Provider Business Mailing Address
First Line	:	1114 ELI CONNOR DR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4800
Country	:	US
Telephone Number	:	318-465-5184
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 CHINABERRY DR STE 502
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-2462
Country	:	US
Telephone Number	:	318-465-5184
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2020
Last Update Date	:	07/17/2024

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Directions to “ TIFFANY ST JOHN VOINCHE ” Practice Location

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