Individual provider Active NPI

Tiffany Annette Cloud, MSW, LMSW

  • Clinical Social Worker
  • Fayetteville, AR
National Provider Identifier
1831688381
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9605-M Issued in AR
Practice address
3715 N Business Dr Ste 104
Fayetteville, AR 72703-5287
Phone
(479) 521-1532
Fax
(479) 521-9940
NPI assigned
May 9, 2018
Last updated
Jun 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9605-M AR Primary

Addresses

Primary practice location

3715 N Business Dr Ste 104
Fayetteville, AR 72703-5287

Mailing address

2153 E Joyce Blvd Ste 201
Fayetteville, AR 72703-5285
Phone (479) 575-9471

Other identifiers 1

IdentifierTypeStateIssuer
231146795MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20231011002486 AR Practitioner - Clinical Social Worker 0042665044 Reassigns benefits to 1 organization
Practice locations: Rogers, AR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3333 S Pinnacle Hills Pkwy
Suite 435
Rogers, AR 72758-9095
Phone (479) 279-8401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9605-MARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chenal Family Therapy, PLC CurrentSince Aug 27, 2023 Accepting new patients
Transitions Counseling Clinic PLC Clinical PastSince Apr 9, 2023 Accepting new patients

Locations

632 W Lancashire Blvd
Bella Vista, AR 72715

304 W Collin Raye Dr
Ste 103A
De Queen, AR 71832
Phone (870) 200-9294

10311 W Markham St
Little Rock, AR 72205
Phone (501) 681-3300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1831688381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2153 E JOYCE BLVD STE 201",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035285",
            "telephone_number": "479-575-9471",
            "fax_number": "479-587-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 N BUSINESS DR STE 104",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035287",
            "telephone_number": "479-521-1532",
            "fax_number": "479-521-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUD",
        "first_name": "TIFFANY",
        "middle_name": "ANNETTE",
        "credential": "MSW, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "9605-M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231146795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.