Provider Demographics
NPI:1790799336
Name:THOMPSON, TIFFANIE ANN (LCSW, LMHP)
Entity type:Individual
Prefix:MS
First Name:TIFFANIE
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 S 175TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2820
Mailing Address - Country:US
Mailing Address - Phone:402-917-7217
Mailing Address - Fax:
Practice Address - Street 1:10845 HARNEY ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2639
Practice Address - Country:US
Practice Address - Phone:402-916-9421
Practice Address - Fax:402-999-8221
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12461041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical