Look up the most recent NPI and PECOS records

Tiffany Carlson

Counselor

Behavioral Health & Social Service Providers

3898 Via Poinciana, 13, Lake Worth, FL 33467-2951

PECOS Enrollment

Based on the most recent information from CMS, provider Tiffany Carlson is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1043762271
Provider Type
Individual
Full Name
Carlson, Tiffany
Gender
Female

Sole Proprietor
Yes
Enumeration Date
11/4/2016
Last Updated
11/4/2016

Contact Information

Practice Location

3898 Via Poinciana, 13, Lake Worth, FL 33467-2951

(561) 967-2566

Unlisted Fax

Mailing Location

7423 74th Way, West Palm Beach, FL 33407-6735

(561) 676-9541

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License MH13770 Florida

Tiffany Carlson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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