MEDICARE: TIFFANY CLAIRE ASHE 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
1	1041C0700X	Clinical Social Worker	C011065	NC

General Provider Information

NPI Number	:	1295255263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY CLAIRE ASHE LCSW

Provider Business Mailing Address
First Line	:	3600 N DUKE STREET #1185
Second Line	:	STE 1
City	:	DURHAM
State	:	NC
Zip	:	27704-3232
Country	:	US
Telephone Number	:	919-887-9464
Fax Number	:	919-551-7468

Provider Business Practice Location Address
First Line	:	421 PANORAMA PARK PL
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-0857
Country	:	US
Telephone Number	:	919-884-9464
Fax Number	:

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

Provider Enumeration Date	:	06/21/2017
Last Update Date	:	05/22/2024

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