Provider Demographics
NPI:1952006579
Name:WHISMAN, TIFFANY (CDCA)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:WHISMAN
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:BUSSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 GALLIA ST STE 600
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4097
Mailing Address - Country:US
Mailing Address - Phone:740-353-4673
Mailing Address - Fax:
Practice Address - Street 1:800 GALLIA ST STE 600
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4097
Practice Address - Country:US
Practice Address - Phone:740-353-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator