Flippen, Tiffany Shell

Flippen, Tiffany Shell is an individual health care provider with primary practice located at 1016 E. Roosevelt Ave. , Grants NM 87020. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Flippen, Tiffany Shell can be contacted via phone (505) 287-5211.

Contact Information

Primary practice address
1016 E. Roosevelt Ave. Grants NM 87020
Phone: (505) 287-5211
Fax: (505) 287-6737
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1104453836
LBN Legal business name Flippen, Tiffany Shell
Credentials LSAA
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2020
Last updated Mar 24th, 2020 - about 4 years 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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Identifiers

StateTypeNumberIssuer
All States NPI 1104453836 NPPES
New Mexico MEDICAID 00729

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