Provider Demographics
NPI:1275890626
Name:GREENE, TIFFANY CHRISTINA (MS, LPC-MHSP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:CHRISTINA
Last Name:GREENE
Suffix:
Gender:F
Credentials:MS, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9041 EXECUTIVE PARK DR STE 275B
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4621
Mailing Address - Country:US
Mailing Address - Phone:865-338-5384
Mailing Address - Fax:865-338-5383
Practice Address - Street 1:9041 EXECUTIVE PARK DR STE 275B
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4621
Practice Address - Country:US
Practice Address - Phone:865-338-5384
Practice Address - Fax:865-338-5383
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3291101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ008900Medicaid