Derrick, Tiffany R

Derrick, Tiffany R is an individual health care provider with primary practice located at 629 Dawsonville Hwy Ste 2201 , Gainesville GA 30501-2632. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Derrick, Tiffany R can be contacted via phone (678) 701-8477.

Contact Information

Primary practice address
629 Dawsonville Hwy Ste 2201 Gainesville GA 30501-2632
Phone: (678) 701-8477
Fax: (229) 516-1395
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X 180.009330 Illinois
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC008265 Georgia

Profile Details

NPI number 1124399589
LBN Legal business name Derrick, Tiffany R
Credentials LCPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2012
Last updated Jan 25th, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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