MEDICARE: TIFFANY CHIANTI RODGERS LCSW, BCABA

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	103K00000X	Behavior Analyst	BACB372034	FL
2	106E00000X	Assistant Behavior Analyst
3	1041C0700X	Clinical Social Worker	ISW7322	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437583580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY CHIANTI RODGERS LCSW, BCABA

Provider Business Mailing Address
First Line	:	5967 RIDGE LAKE CIR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-5093
Country	:	US
Telephone Number	:	772-480-3490
Fax Number	:

Provider Business Practice Location Address
First Line	:	5967 RIDGE LAKE CIR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-5093
Country	:	US
Telephone Number	:	772-480-3490
Fax Number	:

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

Provider Enumeration Date	:	08/26/2013
Last Update Date	:	03/14/2023

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Directions to “ TIFFANY CHIANTI RODGERS LCSW, BCABA” Practice Location

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