Individual provider Active NPI

Tiffany Pallas, LCSW, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Wellington, CO
National Provider Identifier
1912333162
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ACC.0006981 Issued in CO
Practice address
3101 Alybar Dr Unit 4C
Wellington, CO 80549-1546
Phone
(970) 402-6793
NPI assigned
Sep 19, 2013
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACC.0006981 CO Primary
Clinical Social Worker 1041C0700X CSW09924421 CO

Addresses

Primary practice location

3101 Alybar Dr Unit 4C
Wellington, CO 80549-1546

Mailing address

3101 Alybar Dr Unit 4C
Wellington, CO 80549-1546
Phone (970) 402-6793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20160914000077 CO Practitioner - Clinical Social Worker 7810283033 Reassigns benefits to 1 organization
Practice locations: Wellington, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Denver, CO 80202
Phone (323) 205-7088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACC.0006981COMDAddiction (Substance Use Disorder) Counselor
CSW09924421COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince Jul 1, 2025 Accepting new patients

Locations

1560 Broadway
Denver, CO 80202
Phone (623) 363-6103

1560 Broadway
Ste 1600
Denver, CO 80202
Phone (480) 493-0900

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, 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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1912333162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 ALYBAR DR UNIT 4C",
            "city": "WELLINGTON",
            "state": "CO",
            "postal_code": "805491546",
            "telephone_number": "970-402-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 ALYBAR DR UNIT 4C",
            "city": "WELLINGTON",
            "state": "CO",
            "postal_code": "805491546",
            "telephone_number": "970-402-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLAS",
        "first_name": "TIFFANY",
        "credential": "LCSW, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACC.0006981",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW09924421",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, CO

Sources for this page

Verify at the official NPI Registry.