Provider Demographics
NPI:1851099295
Name:PIRKL, TIFFANY R (MA, LPCC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:R
Last Name:PIRKL
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 HIDDEN VALLEY RD APT 87
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-3136
Mailing Address - Country:US
Mailing Address - Phone:763-339-5819
Mailing Address - Fax:
Practice Address - Street 1:3601 MINNESOTA DR STE 170
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55435-5202
Practice Address - Country:US
Practice Address - Phone:952-299-6949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC04788101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN251S00000XMedicaid