Matthew Tiffany, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC3955 Issued in ME

Practice address

11 Medical Center Dr
Brunswick, ME 04011-2690

Phone

(207) 373-9417

NPI assigned

Jun 2, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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

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 and National Provider Directory roles.

• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1760507297
  Medicare reassignment NPD
• Mt Counseling, LLC

  • Adult Mental Health Clinic/Center
  • Brunswick, ME
  • NPI 1992531081
  NPD Authorized official
• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1316945090
  NPD (past)

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1336308709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 MAINE ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112031",
            "telephone_number": "207-518-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MEDICAL CENTER DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112690",
            "telephone_number": "207-373-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIFFANY",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-02",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC3955",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC3955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Thornton
• Charles Russell Thorp, R. PH.
• Kathryn Holby Thorson, NP
• Mark Kenneth Thrall, AA, LMT, OTA
• Andreas P. Thyssen, M.D.
• Jeffrey Tillinghast
• Sandy Timberlake-Tibbetts, LCSW-CC
• Patrick James Tolosky, MD
• Andrea T Tomaselli, PT, MSPT
• Mary D Toof, LCPC

• Professional Counselor in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.