Kathryn Tiffany

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-17398 Issued in AZ

Practice address

4140 E Baseline Rd Ste 101
Mesa, AZ 85206-4413

Phone

(480) 712-5779

NPI assigned

Dec 3, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• East Valley PTSD Counseling

  • Mental Health Counselor
  • Mesa, AZ
  • NPI 1689346561
  NPD Authorized official

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1487291993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 W BASELINE RD UNIT 2114",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852025763",
            "telephone_number": "480-789-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064413",
            "telephone_number": "480-712-5779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1645 W Baseline Rd Unit 2114",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852025763",
            "country_code": "US",
            "telephone_number": "480-789-9015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIFFANY",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-03",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-17398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "katie.tiffany@exhalerecovery.com",
            "affiliation": "N",
            "address_1": "1645 W Baseline Rd Unit 2114",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852025763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.