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NPI Code Detail

MEDICARE: MRS. TIFFANY FORD MA, LPC

MEDICARE:  MRS. TIFFANY  FORD  MA, 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
1101YM0800XMental Health Counselor84264TX

General Provider Information

NPI Number : 1548923634
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY FORD MA, LPC
Provider Business Mailing Address
First Line : 20903 LAS LOMAS BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-2945
Country : US
Telephone Number : 831-272-2773
Fax Number :
Provider Business Practice Location Address
First Line : 20903 LAS LOMAS BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-2945
Country : US
Telephone Number : 831-272-2773
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2021
Last Update Date : 05/19/2023

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Directions to “ MRS. TIFFANY FORD MA, LPC” Practice Location

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