MEDICARE: MS. TIFFANY MILBOURNE-JAMES LCSW, CEAP

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	1041C0700X	Clinical Social Worker	CSW006627	GA

General Provider Information

NPI Number	:	1801226147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIFFANY MILBOURNE-JAMES LCSW, CEAP

Provider Business Mailing Address
First Line	:	304 GREYTHORNE DR
Second Line	:	GREYTHORNE DRIVE
City	:	KATHLEEN
State	:	GA
Zip	:	31047-2899
Country	:	US
Telephone Number	:	478-365-0847
Fax Number	:	478-551-3359

Provider Business Practice Location Address
First Line	:	2525 MOODY RD STE 122
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-6110
Country	:	US
Telephone Number	:	478-365-0847
Fax Number	:	478-551-3359

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

Provider Enumeration Date	:	11/23/2013
Last Update Date	:	04/15/2026

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