Provider Demographics
NPI:1366068082
Name:SIEFKEN, TIFFANY M (LCSW/LISW)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:M
Last Name:SIEFKEN
Suffix:
Gender:F
Credentials:LCSW/LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 YEARLING DR APT 203
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4469
Mailing Address - Country:US
Mailing Address - Phone:319-316-2262
Mailing Address - Fax:888-375-1723
Practice Address - Street 1:2250 YEARLING DR APT 203
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4469
Practice Address - Country:US
Practice Address - Phone:319-316-2262
Practice Address - Fax:888-375-1723
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1008641041C0700X
CO099302931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical