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NPI Code Detail

MEDICARE: TIFFANY D LEMERY LCSW

MEDICARE: TIFFANY D LEMERY LCSW
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
11041C0700XClinical Social Worker179073AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639684749
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY D LEMERY LCSW
Provider Business Mailing Address
First Line : 1002 BILL CIR
Second Line :
City : VAN BUREN
State : AR
Zip : 72956-6684
Country : US
Telephone Number : 912-674-0417
Fax Number :
Provider Business Practice Location Address
First Line : 7335 E PALMER WASILLA HWY STE 2B
Second Line :
City : PALMER
State : AK
Zip : 99645-7710
Country : US
Telephone Number : 907-745-6200
Fax Number : 907-745-6211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2017
Last Update Date : 09/23/2025

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Directions to “ TIFFANY D LEMERY LCSW” Practice Location

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