Mallory Tiffany, LMHC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH20318 Issued in FL

Practice address

7901 4TH St N # 12833
St Petersburg, FL 33702-4305

Phone

(813) 658-8985

NPI assigned

Aug 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mallory Diaz Former name

Medicare fee-for-service enrollment

Enrolled in FL, MO2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MO

  Medicare reassignment
• Brightside Health, Inc.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1073072658

  FL

  Medicare reassignment
• Mindpath Health Florida, PLLC

  • Psychiatry Physician
  • Coral Springs, FL
  • NPI 1467467266

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1982251633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N # 12833",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024305",
            "telephone_number": "813-658-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N # 12833",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024305",
            "telephone_number": "813-658-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIFFANY",
        "first_name": "MALLORY",
        "name_prefix": "Mrs.",
        "credential": "LMHC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20318",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2023030592",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "830128243",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117516600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "DIAZ",
            "credential": "LMHC, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charmalyn Robinson Thurman, PHARMD
• James E Thurman Jr., C.S.B.
• Courtney O'Connell Tibbetts
• Catherine Anne Tiehaara, CRNA
• Jessica Lee Tieman, RN
• Sydney Tiiman
• Tikvah Counseling, LLC
• Hephzibah Ebony Tillery, ARNP
• Ariana Tilley
• Jordyn E Tilman, M.A.

• Mental Health Counselor in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.