MEDICARE: TIFFANY GREEN M.ED, NCC, LPC

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	101YP2500X	Professional Counselor	5194	CT

General Provider Information

NPI Number	:	1336801281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY GREEN M.ED, NCC, LPC

Provider Business Mailing Address
First Line	:	PO BOX 27280
Second Line	:
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-8280
Country	:	US
Telephone Number	:	203-912-0254
Fax Number	:

Provider Business Practice Location Address
First Line	:	1408 MARK CT
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-3568
Country	:	US
Telephone Number	:	203-912-0254
Fax Number	:

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

Provider Enumeration Date	:	10/07/2021
Last Update Date	:	10/07/2021

Similar Medicare Providers

1851627046 — MR. MARWAN HATTAB R.PH.
Practice Location Address:

6904 OCEANO TER
FORT WORTH, TX
76132-3568

Practice Phone: 817-966-0140
Practice Fax:

1073829560 — DR. VUONG BA MAI D.O.
Practice Location Address:

9016 QUARTER HORSE LN
FORT WORTH, TX
76123-3568

Practice Phone: 817-768-7772
Practice Fax:

1457179483 — JENNIFER MORA HERRERA
Practice Location Address:

3568 DAVIS LANDINGS CIR
LAKE WORTH, FL
33461-5540

Practice Phone: 561-888-5432
Practice Fax:

1497010052 — STACEY HEIDLER
Practice Location Address:

6315 PRESIDENTIAL CT STE 110
FORT MYERS, FL
33919-3568

Practice Phone: 239-826-2152
Practice Fax:

1932541901 — MRS. CARRIE LYNN JOHNSON MS, NCC, LMHC
Practice Location Address:

6315 PRESIDENTIAL CT STE 120
FORT MYERS, FL
33919-3568

Practice Phone: 239-312-5352
Practice Fax: 239-230-3029

1942740253 — DENA PANICCIA LCSW
Practice Location Address:

6315 PRESIDENTIAL CT STE 110
FORT MYERS, FL
33919-3568

Practice Phone: 239-450-7155
Practice Fax:

Directions to “ TIFFANY GREEN M.ED, NCC, LPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.