Tiffany Perry-Wilson, PHD, LPC, LCPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

173 Saint Patricks Dr Ste 104
Waldorf, MD 20603-5530

Phone

(571) 474-2750

NPI assigned

Apr 25, 2018

Last updated

May 31, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Psychological and Life Skills Associates, P.C.

  • Psychologist
  • Woodbridge, VA
  • NPI 1619066727
  Medicare reassignment NPD
• The Elevated Mind Collective LLC

  • Mental Health Counselor
  • Waldorf, MD
  • NPI 1497639850
  NPD Authorized official
• Family Service Center of Galveston County, Texas

  • Mental Health Counselor
  • Galveston, TX
  • NPI 1902871833
  NPD (past)

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780185600000",
    "number": "1265920219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 SAINT PATRICKS DR STE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035530",
            "telephone_number": "571-474-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 SAINT PATRICKS DR STE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035530",
            "telephone_number": "571-474-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY-WILSON",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, LCPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pembrooke Health Services LLC (Pembrooke Pharmacy)
• Pembrooke Square ENT Associates, LLC
• Pembrooke Square Surgery Center, LLC
• Tina Lorice Penny
• Alyssa Peppins
• Alexandra Perry
• Sarah Catherine Persinger, RN
• Personalized Therapy, LLC
• Personalized Therapy, LLC
• Deidhra Peter-Thomas

• Mental Health Counselor in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.