MEDICARE: TIFFANY CRYSTAL REESE MS, 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	10616	SC

General Provider Information

NPI Number	:	1568033074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY CRYSTAL REESE MS, LPC

Provider Business Mailing Address
First Line	:	1565 SAM RITTENBERG BLVD STE 202B
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4138
Country	:	US
Telephone Number	:	843-284-6423
Fax Number	:

Provider Business Practice Location Address
First Line	:	1565 SAM RITTENBERG BLVD # 202B
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4138
Country	:	US
Telephone Number	:	843-284-6423
Fax Number	:

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

Provider Enumeration Date	:	07/06/2021
Last Update Date	:	01/11/2026

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