MS. TIFFANY RENEE' ELLIS
NPI 1699964585
Counselor - Addiction (Substance Use Disorder) in South Lake Tahoe, CA
Active since October 17, 2007
About Ms. Tiffany Renee' Ellis NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. TIFFANY RENEE' ELLIS (NPI 1699964585) is an individual addiction (substance use disorder) provider in South Lake Tahoe, California and active in the NPI registry since October 2007.
NPPES Registry Identity
NPI1699964585
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMS. TIFFANY RENEE' ELLIS
Location Address1120 3RD STSouth Lake Tahoe, CA 96150-3451
Mailing Address1120 3rd StSouth Lake Tahoe, CA 96150-3451 · (530) 573-3386 · Fax (530) 543-6697
Phone(530) 573-3386
Fax(530) 543-6697
Sole ProprietorNo
Enumeration DateOctober 17, 2007
✔ NPI 1699964585 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
1120 3RD ST, South Lake Tahoe, CA 96150
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Day Training, Developmentally Disabled Services
1120 3RD ST
SOUTH LAKE TAHOE, CA 96150
SOUTH LAKE TAHOE, CA 96150
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1699964585, enumerated as an "individual" on October 17, 2007.
The provider is located at 1120 3RD ST SOUTH LAKE TAHOE, CA 96150 and the phone number is (530) 573-3386.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
