Provider Demographics
NPI:1902656879
Name:CARPIO, TIFFANY STACY (MHC-LP)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:STACY
Last Name:CARPIO
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 GRUMMAN ROAD
Mailing Address - Street 2:SUIT. 1000
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714
Mailing Address - Country:US
Mailing Address - Phone:516-542-0404
Mailing Address - Fax:
Practice Address - Street 1:15 GRUMMAN ROAD WEST
Practice Address - Street 2:SUIT 1000
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714
Practice Address - Country:US
Practice Address - Phone:516-542-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP123342101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health