On Epiphany Lane, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ON EPIPHANY LANE, LLC

Practice address

603 Munger Ave Ste 100
Dallas, TX 75202-1840

Phone

(214) 560-0304

NPI assigned

Nov 2, 2020

Organization subpart

No

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

Authorized official

Name

Tiffany Neulene Lindley, LPC-SNPI 1215272737

Title

Managing Member

Phone

(214) 560-0304

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Epiphany Lane Counseling Doing business as

Locations

Practitioners 1

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

• Tiffany N Lindley, LPC

  • Professional Counselor
  • Dallas, TX
  • NPI 1215272737
  NPD Authorized official

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1891396313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 MUNGER AVE # 100-239",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752021839",
            "telephone_number": "214-560-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 MUNGER AVE STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752021840",
            "telephone_number": "214-560-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON EPIPHANY LANE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "LINDLEY",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "NEULENE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "214-560-0304",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215272737",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Epiphany Lane Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Owen O Omoragbon, NP
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• Jade On, D.M.D.
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• Multi-Specialty Clinic/Center in Dallas, TX
• Providers in Dallas, TX by specialty
• Multi-Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.