Resilient Driven Life, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RESILIENT DRIVEN LIFE, LLC

Practice address

602 Adeline St # B2
Hattiesburg, MS 39401-3802

Phone

(601) 408-0448

NPI assigned

May 31, 2022

Last updated

May 31, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tiffiney R Hill, LCSWNPI 1225408115

Title

Owner

Phone

(601) 408-0448

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tiffiney Renee' Hill, LCSW

  • Clinical Social Worker
  • Hattiesburg, MS
  • NPI 1225408115
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653955200000",
    "number": "1649919614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 LAKELAND CIR",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394658716",
            "telephone_number": "601-408-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 ADELINE ST # B2",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013802",
            "telephone_number": "601-408-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT DRIVEN LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "TIFFINEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-408-0448",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.