Provider Demographics
NPI:1548357304
Name:ALLEN-DURAN, TIFFANY SHANNON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:SHANNON
Last Name:ALLEN-DURAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3326
Mailing Address - Country:US
Mailing Address - Phone:936-637-0074
Mailing Address - Fax:936-637-0081
Practice Address - Street 1:1214 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3326
Practice Address - Country:US
Practice Address - Phone:936-637-0074
Practice Address - Fax:936-637-0081
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2937-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical