Individual
KARL SCOTT TIFFANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
6550 W EMERALD ST, BOISE, ID 83704-8780
(208) 342-6300
Mailing address
2726 N LAPIS AVE, MERIDIAN, ID 83646-1559
(480) 250-4603
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10-R-31
OR
101YM0800X
Mental Health Counselor
Primary
LCPC5257
ID
101YP2500X
Professional Counselor
C2797
OR
Other
Enumeration date
01/18/2012
Last updated
12/01/2020
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