Tiffany Faye Vanderziel, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC02622 Issued in MN

Practice address

201 N Broad St Ste 200
Mankato, MN 56001-3569

Phone

(507) 335-1500

Fax

(507) 225-1501

NPI assigned

Sep 26, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Fernbrook Family Center IncGroup PAC ID 3870872914, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fernbrook Family Center, Inc

  • Social Worker
  • Owatonna, MN
  • NPI 1659483915
  Medicare reassignment Care Compare group NPD
• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Fernbrook Family Center

  • Social Worker
  • Red Wing, MN
  • NPI 1437427911
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1003391012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N BROAD ST STE 200",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560013569",
            "telephone_number": "507-225-1500",
            "fax_number": "507-225-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N BROAD ST STE 200",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560013569",
            "telephone_number": "507-335-1500",
            "fax_number": "507-225-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERZIEL",
        "first_name": "TIFFANY",
        "middle_name": "FAYE",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prentice Valvick
• Taylor Van Allen, MSW, LICSW
• Sonja Van Note
• Hannah Jo Van Otterloo, LGSW
• Nicholas Allen Van Peursem, PHARMD
• Ia Vang
• Karla K Vanlith, CRNA
• Mary R Vanravenhorst, OTR/L
• Kornpong Vantanasiri, M.D.
• Lisa Vanwatermulen, RN, NP

• Professional Counselor in Mankato, MN
• Providers in Mankato, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.