Tiffany Kayla Bragg, CDCA, QMHS, CMS
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Tiffin, OH
NPI 1437669017 · NPPES record last updated Oct 9, 2017
Key facts
- NPI
- 1437669017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CDCA.164477 (OH)
- Practice address
- 76 Ashwood Dr
Tiffin, OH 44883-1908 - Phone
- (419) 448-9440
- Fax
- (419) 448-5155
- NPI assigned
- Oct 9, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.164477 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.164477 | OH | Yes |
Addresses
Primary practice location
76 Ashwood Dr
Tiffin, OH 44883-1908
Mailing address
1925 Hayes Ave
Sandusky, OH 44870-4737
Phone (419) 557-5177
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YA0400X | Medicaid | OH | |
| 101YM0800X | Medicaid | OH |
Other providers in Tiffin, OH
- Stacy Lea Borgio
- James Frederick Bosse
- Joshua Bower
- Ashton Bowerman
- Betsey Lynn Brady
- Tanveer Singh Brar
- John W Bremyer
- Joanne Louise Brickner
- Staci Brickner
- Bridges Community Academy
All providers in Tiffin, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.