MEDICARE: TIFFANY HUSKINS LSW

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	104100000X	Social Worker	S.2207838	OH

General Provider Information

NPI Number	:	1821688573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY HUSKINS LSW

Provider Business Mailing Address
First Line	:	7550 LUCERNE DR STE 101
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-6503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7550 LUCERNE DR STE 101
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-6503
Country	:	US
Telephone Number	:	440-583-3500
Fax Number	:

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

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	08/28/2025

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