Tiffany M Woods, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180009910 Issued in IL

Practice address

1044 Ferdinand Ave
Forest Park, IL 60130-2204

Phone

(708) 296-1253

NPI assigned

May 30, 2020

Last updated

May 30, 2020By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1590796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590796800000",
    "number": "1376167957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 FERDINAND AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302204",
            "telephone_number": "708-296-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 FERDINAND AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302204",
            "telephone_number": "708-296-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-30",
        "last_updated": "2020-05-30",
        "certification_date": "2020-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khairee Williams
• Skyy Derajane Williams, RBT
• Julianna Elizabeth Holzer Winter
• Vanessa Wittich
• Joshua Woodruff, DMD
• Cassie Rose Yoder, M.A., LPC
• Michelle Marie Zadelek, M.A.

• Professional Counselor in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2020; 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.