Provider Demographics
NPI:1275418824
Name:STEWART, TIFFANY BURTON (ALC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:BURTON
Last Name:STEWART
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 18TH ST W FL 1
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-5363
Mailing Address - Country:US
Mailing Address - Phone:205-582-4345
Mailing Address - Fax:
Practice Address - Street 1:200 18TH ST W FL 1
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-5363
Practice Address - Country:US
Practice Address - Phone:205-582-4345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05671101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor