Tiffany Douglas, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CO12158 Issued in NC

Practice address

6719 Running Fox Rd
Hope Mills, NC 28348-2993

Phone

(910) 644-0871

NPI assigned

Nov 22, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Tiffany Douglas LCSW Counseling and Consulting

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hope Mills, NC
  • NPI 1528773603
  NPD Authorized official

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1992248074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 RUNNING FOX RD",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283482993",
            "telephone_number": "910-644-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 RUNNING FOX RD",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283482993",
            "telephone_number": "910-644-0871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 Village Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283044513",
            "country_code": "US",
            "telephone_number": "910-500-1800",
            "fax_number": "910-500-1795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5228 NC Hwy 211",
            "address_purpose": "LOCATION",
            "city": "West End",
            "state": "NC",
            "postal_code": "27376",
            "country_code": "US",
            "telephone_number": "910-673-8512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "TIFFANY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "CO12158",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Hope Mills, NC
• Providers in Hope Mills, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.