Individual provider Active NPI

Tiffany Wilson, MFT, LCDC, LSOTP

  • Marriage & Family Therapist
  • Missouri City, TX
National Provider Identifier
1952110983
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
203929 Issued in GA
Practice address
4220 Cartwright Rd Ste 401
Missouri City, TX 77459-5310
Phone
(346) 440-1800
NPI assigned
Jan 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 203929 GA Primary

Addresses

Primary practice location

4220 Cartwright Rd Ste 401
Missouri City, TX 77459-5310

Mailing address

100 Postmaster Dr Unit 876
McDonough, GA 30253-2808

Other names 1

  • Tiffany Roschyk Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
203929GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cynthia L. Rojas Counseling PLLC CurrentSince Jan 5, 2025 Accepting new patients
Eagle's Landing Christian Counseling Center, Inc. Past Accepting new patients

Locations

4220 Cartwright Rd
Ste 401
Missouri City, TX 77459
Phone (346) 440-1800

Organizations & group practices 2

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": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1952110983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 POSTMASTER DR UNIT 876",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302532808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 CARTWRIGHT RD STE 401",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774595310",
            "telephone_number": "346-440-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TIFFANY",
        "credential": "MFT, LCDC, LSOTP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-03",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "203929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "ROSCHYK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.