Individual provider Active NPI

Tiffany R Hersman, MA, BSW, AAS

  • Social Worker
  • Charleston, WV
National Provider Identifier
1386346112
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
428 Leon Sullivan Way
Charleston, WV 25301
Phone
(304) 409-8128
NPI assigned
Mar 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
School Counselor 101YS0200X F5E133500197 WV
Social Worker 104100000X Primary

Addresses

Primary practice location

428 Leon Sullivan Way
Charleston, WV 25301

Mailing address

166 Anniston Dr
Point Pleasant, WV 25550-2149
Phone (304) 419-5106

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
Associate of Applied Science, Master of Arts

State licenses

LicenseStateTypeSpecialty
F5E133500197WVMDSchool Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mustard Seed Counseling and Behavioral Health Services LLC CurrentSince May 12, 2024 Accepting new patients
Cornerstone Medical Group of West Virginia LLC CurrentSince Sep 8, 2025 Accepting new patients

Locations

428 Leon Sullivan Way
Charleston, WV 25301
Phone (304) 409-8128

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1386346112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 ANNISTON DR",
            "city": "POINT PLEASANT",
            "state": "WV",
            "postal_code": "255502149",
            "telephone_number": "304-419-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 LEON SULLIVAN WAY",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25301",
            "telephone_number": "304-409-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSMAN",
        "first_name": "TIFFANY",
        "middle_name": "R",
        "credential": "MA, BSW, AAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "WV",
            "license": "F5E133500197",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.