Tiffany Holland, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5480 Issued in SC

Legal business name

TIFFANY HOLLAND, LLC

Practice address

80 Ladys Island Dr
Beaufort, SC 29907-1643

Phone

(843) 476-7421

NPI assigned

Apr 15, 2016

Organization subpart

No

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

Authorized official

Name

Kimberlt Davis

Title

Credentialing Specialists

Phone

(912) 484-3879

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460678400000",
    "number": "1588018543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846",
            "city": "SAINT HELENA ISLAND",
            "state": "SC",
            "postal_code": "299200846",
            "telephone_number": "843-476-7421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 LADYS ISLAND DR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299071643",
            "telephone_number": "843-476-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY HOLLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2016-04-15",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KIMBERLT",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALISTS",
        "authorized_official_telephone_number": "912-484-3879"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "5480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1361",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.