Provider Demographics
NPI:1356792519
Name:POPE, TIFFANY (LPC, NCC, CPCS)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:LPC, NCC, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 FOGGY OAK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-4686
Mailing Address - Country:US
Mailing Address - Phone:706-231-2008
Mailing Address - Fax:800-419-9018
Practice Address - Street 1:6303 FOGGY OAK DR
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-4686
Practice Address - Country:US
Practice Address - Phone:706-231-2008
Practice Address - Fax:800-419-9018
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA LPC 009013101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional