Tiffany Blake Woods, LCMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A18274 Issued in NC

Practice address

3305 Healy Dr
Winston Salem, NC 27103-1406

Phone

(336) 448-4451

Fax

(336) 450-1884

NPI assigned

Apr 8, 2024

Last updated

Apr 8, 2024By 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

Enrolled in NC

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banyan Tree Counseling PLLCGroup PAC ID 8022524842, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Banyan Tree Counseling PLLC

  dba Banyan Tree Counseling and Wellness

  • Counselor
  • Winston Salem, NC
  • NPI 1720619968

  Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1457104978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 SUNNYSIDE AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273050",
            "telephone_number": "336-306-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 HEALY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031406",
            "telephone_number": "336-448-4451",
            "fax_number": "336-450-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "TIFFANY",
        "middle_name": "BLAKE",
        "credential": "LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Katherine Woodruff, M.D.
• Ralph Dutton Woodruff, MD
• Tyler Woodrum, MD
• Kawanna Teresa Woods-Willis
• David K Woods, D.M.D
• Abigail Woodson, RBT
• Faraji Woodson
• Lakisha Kay Woodson, LCSWA
• Tanya Sue Woodson, PAC
• Taylor Wayne Woodward

• Mental Health Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.