| Tiffany Summers | |
|
123 Pronghorn Deer Ct Garner NC 27529-7186 | |
| (252) 432-0948 | |
| Not Available |
| Full Name | Tiffany Summers |
|---|---|
| Speciality | Social Worker |
| Location | 123 Pronghorn Deer Ct, Garner, North Carolina |
| Authorized Official Name and Position | Tiffany Summers (THERAPIST) |
| Authorized Official Contact | 9195251467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tiffany Summers 1220 Timber Dr E # 1021 Garner NC 27529-6917 Ph: (919) 525-1461 | Tiffany Summers 123 Pronghorn Deer Ct Garner NC 27529-7186 Ph: (252) 432-0948 |
| NPI Number | 1972289668 |
|---|---|
| Provider Enumeration Date | 06/26/2023 |
| Last Update Date | 08/17/2023 |
| Certification Date | 08/17/2023 |
| Medicare PECOS PAC ID | 9638523137 |
|---|---|
| Medicare Enrollment ID | O20231003001594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972289668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tiffany Summers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679132633 PECOS PAC ID: 8628469509 Enrollment ID: I20220104000881 |
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