Individual provider Active NPI

Tiffiney Renee' Hill, LCSW

  • Clinical Social Worker
  • Hattiesburg, MS
National Provider Identifier
1225408115
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C7692 Issued in MS
Practice address
602 Adeline St Ste B2
Hattiesburg, MS 39401-3802
Phone
(769) 301-9280
NPI assigned
Oct 5, 2015
Last updated
Jul 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C7692 MS Primary

Addresses

Primary practice location

602 Adeline St Ste B2
Hattiesburg, MS 39401-3802

Mailing address

602 Adeline St Ste B2
Hattiesburg, MS 39401-3802

Other practice location 1

232 Market St
Flowood, MS 39232-3339
Phone (601) 951-9863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160316000554 MS Practitioner - Clinical Social Worker 9335445402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

602 Adeline St
B2
Hattiesburg, MS 39401-3802
Phone (601) 408-0448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Behavioral Medicine Associates PLLC CurrentSince Apr 5, 2024 Accepting new patients
Resilient Driven Life, LLC Clinical CurrentSince Jun 1, 2022 Accepting new patients

Locations

1 Commerce Dr
Ste 106
Hattiesburg, MS 39402
Phone (601) 255-1618

602 Adeline St
Ofc
Hattiesburg, MS 39401
Phone (601) 408-0448

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1225408115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 ADELINE ST STE B2",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 ADELINE ST STE B2",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013802",
            "telephone_number": "769-301-9280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 Market St",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392323339",
            "country_code": "US",
            "telephone_number": "601-951-9863",
            "fax_number": "601-487-8897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILL",
        "first_name": "TIFFINEY",
        "middle_name": "RENEE'",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.