Individual
MR. CHARLES EDWIN TIFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW, NCAC II, CCS
Contact information
Practice address
210 GARDEN CIR, HINESVILLE, GA 31313-4421
(912) 977-4663
(912) 369-6530
Mailing address
36 COATES RD, HINESVILLE, GA 31313-1013
(912) 369-5973
(912) 369-6530
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
012789
GA
1041C0700X
Clinical Social Worker
Primary
MSW002656
GA
Other
Enumeration date
11/09/2005
Last updated
08/04/2010
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