Tiffeny Mack, M. ED; PLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2017021470 Issued in MO

Practice address

1340 Belt Ave
Saint Louis, MO 63112-4115

Phone

(314) 266-8858

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1922591841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12384 TRIBUTARY DR APT J",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630432029",
            "telephone_number": "314-266-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BELT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124115",
            "telephone_number": "314-266-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "TIFFENY",
        "name_prefix": "Mrs.",
        "credential": "M. ED; PLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2017021470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Mack, RBT
• Katie Mack
• Kimberly Yvette Mack, MAADC I
• Paul Jeffrey Mack, CHTP, ED.D, MS, BA
• Thomas Gerard Mack
• Vivian Renee Mack, LPC
• Micaela Maria Dolores Mackay, MD
• Alan Dean Macke, RPH
• Mackenzie Crossing Chiropractic P.C.
• Chelsey Mackenzie, CNM

• Professional Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.