Tiffany Depp, CDCA,QMHS

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

5577 Airport Hwy Ste 102
Toledo, OH 43615-7364

Phone

(419) 214-1770

NPI assigned

Feb 11, 2019

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1104382563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2238 DUNHAM ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436091639",
            "telephone_number": "419-297-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5577 AIRPORT HWY STE 102",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436157364",
            "telephone_number": "419-214-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2238 Dunham St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436091639",
            "country_code": "US",
            "telephone_number": "419-297-1664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPP",
        "first_name": "TIFFANY",
        "credential": "CDCA,QMHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Veteran Affairs
• Department of Veterans Affairs VA Ann Arbor Healthcare System
• Cyrano Jamal Depp V, QBHS
• Ebony Depp
• Tamara Depp
• Tyrena Depp, CDCA
• Arianna Deppen
• Mary E Derck, ATC
• Corvette R Derden
• Kacynthia Derden, STNA

• All providers in Toledo, OH
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.