Individual provider Active NPI

Tiffany Nicole Brown, PHD

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1336799386
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS018553 Issued in PA
Practice address
2043 Locust St
Philadelphia, PA 19103-5662
Phone
(760) 954-9078
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS018553 PA Primary

Addresses

Primary practice location

2043 Locust St
Philadelphia, PA 19103-5662

Mailing address

1834 Fitzwater St
Philadelphia, PA 19146-1853
Phone (760) 954-9078

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS018553PAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1336799386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 FITZWATER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461853",
            "telephone_number": "760-954-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191035662",
            "telephone_number": "760-954-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS018553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.