MEDICARE: TIFFANY V MOORE LIMHP

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	101YM0800X	Mental Health Counselor	1706	NE
2	1041C0700X	Clinical Social Worker	1687	NE

Other Identifiers

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

General Provider Information

NPI Number	:	1902338452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY V MOORE LIMHP

Provider Business Mailing Address
First Line	:	8790 F ST STE 125
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68127-1529
Country	:	US
Telephone Number	:	402-215-4913
Fax Number	:

Provider Business Practice Location Address
First Line	:	8790 F ST STE 125
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68127-1529
Country	:	US
Telephone Number	:	402-637-6778
Fax Number	:

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

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	07/16/2025

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Directions to “ TIFFANY V MOORE LIMHP” Practice Location

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