Phyllis Tiffany, LCSW
Individual provider Active NPI Clinical Social Worker · Richford, VT
NPI 1104807486 · NPPES record last updated Apr 11, 2008
Key facts
- NPI
- 1104807486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 0890000745 (VT)
- Practice address
- 44 Main St
Suite 200
Richford, VT 05476-1153 - Phone
- (802) 255-5500
- Fax
- (802) 255-5509
- NPI assigned
- Nov 14, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Richford Health Center Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0890000745 | VT | Yes |
Addresses
Primary practice location
44 Main St
Suite 200
Richford, VT 05476-1153
Mailing address
207 Corliss Rd
Richford, VT 05476-1259
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00068810 | Other | VT | BCBS |
| 1011769 | Medicaid | VT |
Other providers in Richford, VT
- Lisha Tang
- The Richford Health Center Inc
- The Richford Health Center Inc.
- The Richford Health Center Inc.
- The Richford Health Center, Inc.
- Town of Richford
- Martha Walker
- Peter Myles Woolhouse
All providers in Richford, VT · Clinical Social Worker in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.