NPIMap

Organization Active NPI

Tiffany Evans

  • Clinical Social Worker
  • Kentwood, MI
National Provider Identifier
1841987484
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TIFFANY EVANS
Practice address
4488 Breton Rd SE
Kentwood, MI 49508-5270
Phone
(616) 340-9026
NPI assigned
Apr 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Tiffany EvansNPI 1689047110
Title
LMSW
Phone
(623) 233-0116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4488 Breton Rd SE
Kentwood, MI 49508-5270

Mailing address

2529 Bridgeport LN SE
Kentwood, MI 49508-8431

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1841987484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 BRIDGEPORT LN SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495088431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4488 BRETON RD SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085270",
            "telephone_number": "616-340-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY EVANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "LMSW",
        "authorized_official_telephone_number": "623-233-0116"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.