Provider Demographics
NPI:1801347620
Name:VANCE-WHIPPLE, TIFFANY (LAC,LCPC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:VANCE-WHIPPLE
Suffix:
Gender:F
Credentials:LAC,LCPC
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:BRYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5420 CERKONEY LN
Mailing Address - Street 2:
Mailing Address - City:SHEPHERD
Mailing Address - State:MT
Mailing Address - Zip Code:59079-4333
Mailing Address - Country:US
Mailing Address - Phone:406-794-9320
Mailing Address - Fax:
Practice Address - Street 1:110 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-6021
Practice Address - Country:US
Practice Address - Phone:406-794-9320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-19343101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)