Individual provider Active NPI

Susan Marie Tiffany, LICSW, LCSW

  • Clinical Social Worker
  • San Marcos, TX
National Provider Identifier
1861708786
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115511 Issued in TX
Practice address
151 Stagecoach TRL Ste 220
San Marcos, TX 78666-3863
Phone
(737) 277-4221
NPI assigned
Aug 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 115511 TX Primary
Clinical Social Worker 1041C0700X LW60869700 WA

Addresses

Primary practice location

151 Stagecoach TRL Ste 220
San Marcos, TX 78666-3863

Mailing address

2627 Martin Way E Ste 5
Olympia, WA 98506-4926
Phone (360) 830-6679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250506000261 TX Practitioner - Clinical Social Worker 4486171253

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

308 S Friendswood Dr
Suite 200
Friendswood, TX 77546-3989

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW60869700WAMDClinical Social Worker
115511TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC Clinical CurrentSince May 1, 2025 Accepting new patients

Locations

308 S Friendswood Dr
Ste 200
Friendswood, TX 77546
Phone (253) 346-0386

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

23051 Kingwood Place Dr
Ste 110
Kingwood, TX 77339
Phone (281) 374-4500

151 Stagecoach Trl
Ste 220
San Marcos, TX 78666
Phone (210) 858-9772

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1861708786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 MARTIN WAY E STE 5",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985064926",
            "telephone_number": "360-830-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 STAGECOACH TRL STE 220",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786663863",
            "telephone_number": "737-277-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIFFANY",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "LICSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "115511",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60869700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

Verify at the official NPI Registry.