Provider Demographics
NPI:1902582646
Name:DAMEWOOD, TIFFANY LYNN (LCSW, LCDC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LYNN
Last Name:DAMEWOOD
Suffix:
Gender:F
Credentials:LCSW, LCDC
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:LYNN
Other - Last Name:WYNIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5105 CROSSVINE LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4694
Mailing Address - Country:US
Mailing Address - Phone:214-535-9503
Mailing Address - Fax:
Practice Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 1202
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1872
Practice Address - Country:US
Practice Address - Phone:469-634-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX583931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical