MEDICARE: MS. TIFANEE LORRAINE LAMPKIN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility	OH
2	324500000X	Substance Abuse Rehabilitation Facility	OH
3	175T00000X	Peer Specialist	OH
4	171M00000X	Case Manager/Care Coordinator	OH
5	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1346102084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIFANEE LORRAINE LAMPKIN

Provider Business Mailing Address
First Line	:	1225 NORWOOD RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-1502
Country	:	US
Telephone Number	:	567-389-2757
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 NORWOOD RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-1502
Country	:	US
Telephone Number	:	567-389-2757
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	03/18/2026

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