Provider Demographics
NPI:1871993246
Name:SIMONETTI, TIFFANY NICOLE (MS, LCPC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:NICOLE
Last Name:SIMONETTI
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8687 W SAHARA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5869
Mailing Address - Country:US
Mailing Address - Phone:702-830-9619
Mailing Address - Fax:702-840-1033
Practice Address - Street 1:8687 W SAHARA AVE STE 201
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5869
Practice Address - Country:US
Practice Address - Phone:702-830-9619
Practice Address - Fax:702-840-1033
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP3282101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional