MEDICARE: MRS. TIFFANY JOVANTE COMPTON MURCHISON LCMHCS, LCAS-A

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-28546	NC
2	101YM0800X	Mental Health Counselor	12407	NC

General Provider Information

NPI Number	:	1588119549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TIFFANY JOVANTE COMPTON MURCHISON LCMHCS, LCAS-A

Provider Business Mailing Address
First Line	:	884 DAW PATE RD NE
Second Line	:
City	:	PIKEVILLE
State	:	NC
Zip	:	27863-9043
Country	:	US
Telephone Number	:	919-587-0001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1503 WAYNE MEMORIAL DR STE E
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-2203
Country	:	US
Telephone Number	:	919-587-0001
Fax Number	:	919-587-0007

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

Provider Enumeration Date	:	08/19/2016
Last Update Date	:	06/22/2026

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