Active NPI
Tiffany McPherson, LCSW
- Clinical Social Worker
- Ammon, ID
National Provider Identifier
1699952663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 30719
- Practice address
- 1329 Ammon Park Dr
Ammon, ID 83406-4591 - Phone
- (208) 709-3164
- NPI assigned
- Jan 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6059007-3501 | UT | |
| Clinical Social Worker | 1041C0700X | 30719 | ID | Primary |
Addresses
Primary practice location
1329 Ammon Park Dr
Ammon, ID 83406-4591
Mailing address
1329 Ammon Park Dr
Ammon, ID 83406-4591
Phone (208) 709-3164
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30719 | ID | MD | Clinical Social Worker |
| 6059007-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1699952663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1329 AMMON PARK DR",
"city": "AMMON",
"state": "ID",
"postal_code": "834064591",
"telephone_number": "208-709-3164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1329 AMMON PARK DR",
"city": "AMMON",
"state": "ID",
"postal_code": "834064591",
"telephone_number": "208-709-3164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCPHERSON",
"first_name": "TIFFANY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-22",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "6059007-3501",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "30719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ammon, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.