Tiffany Conyers, LCSW, LISW-CP, PMH-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12122 Issued in SC

Practice address

603 Newton Rd
Irmo, SC 29063-2952

Phone

(803) 414-4819

Fax

(803) 233-8420

NPI assigned

Jun 22, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tiffany.conyers.1@25307.direct.athenahealth.com

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.

• We Factory, LLC

  • Community/Behavioral Health Agency
  • West Columbia, SC
  • NPI 1912113317

  Clinical

  NPD (past)

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1124256763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 MEETING ST",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291697308",
            "telephone_number": "803-233-3199",
            "fax_number": "803-233-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 NEWTON RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632952",
            "telephone_number": "803-414-4819",
            "fax_number": "803-233-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONYERS",
        "first_name": "TIFFANY",
        "name_prefix": "Ms.",
        "credential": "LCSW, LISW-CP, PMH-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005601",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "12122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11937021",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Pickens Collins, D.M.D.
• Columbia Lactation Care LLC
• Columbia Rehabilitation Clinic, Inc.
• Comfort Home Health Care Inc.
• Comprehensive Counseling
• Kimberly Dunbar Cooney, PA-C
• Cameron Copeland, OD
• James Cordan, PHMARMACIST
• Corehealth Inc
• Jill Corrigan, LISW-CP

• All providers in Irmo, SC
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.