Individual provider Active NPI

Tiffany Perdue, LSW

  • Social Worker
  • Coshocton, OH
National Provider Identifier
1023525151
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1701758 Issued in OH
Practice address
610 Walnut St
Coshocton, OH 43812-1655
Phone
(740) 622-0033
Fax
(740) 622-0210
NPI assigned
Jan 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X S.1701758 OH
Social Worker 104100000X S.1701758 OH Primary

Addresses

Primary practice location

610 Walnut St
Coshocton, OH 43812-1655

Mailing address

610 Walnut St
Coshocton, OH 43812-1655
Phone (740) 622-0033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1701758OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1023525151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 WALNUT ST",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121655",
            "telephone_number": "740-622-0033",
            "fax_number": "740-622-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 WALNUT ST",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121655",
            "telephone_number": "740-622-0033",
            "fax_number": "740-622-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDUE",
        "first_name": "TIFFANY",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "S.1701758",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1701758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coshocton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.