Provider Demographics
NPI:1679751077
Name:SONG, TIFFANY TIPTON (LCSW)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:TIPTON
Last Name:SONG
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 1:2515 BANKSVILLE RD # 1144
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-2809
Mailing Address - Country:US
Mailing Address - Phone:412-228-3255
Mailing Address - Fax:
Practice Address - Street 1:727 PINETREE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1043
Practice Address - Country:US
Practice Address - Phone:412-228-3255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW015469104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker