Active NPI
Tiffany Deriso Laster
- Professional Counselor
- Americus, GA
National Provider Identifier
1174489363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 472 US Highway 280 W
Americus, GA 31719-9107 - Phone
- (229) 886-0146
- NPI assigned
- Dec 31, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | GA | Primary |
Addresses
Primary practice location
472 US Highway 280 W
Americus, GA 31719-9107
Mailing address
472 US Highway 280 W
Americus, GA 31719-9107
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767139200000",
"number": "1174489363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "472 US HIGHWAY 280 W",
"city": "AMERICUS",
"state": "GA",
"postal_code": "317199107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "472 US HIGHWAY 280 W",
"city": "AMERICUS",
"state": "GA",
"postal_code": "317199107",
"telephone_number": "229-886-0146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASTER",
"first_name": "TIFFANY",
"middle_name": "DERISO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-31",
"last_updated": "2025-12-31",
"certification_date": "2025-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Americus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.