Tiffany L Costilla, CDCA
Counselor, Addiction (Substance Use Disorder) in Fremont, OH. Individual provider (NPI-1).
NPI number1811573124
StatusActive
Last updated in NPPESMar 18, 2021
Details
- NPI
- 1811573124
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Tiffany L Costilla
- Credential
- CDCA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 18, 2021
- Certification date
- Mar 18, 2021
- Last updated
- Mar 18, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | CDCA.176199 | OH | Yes |
Other names
- Tiffany L McMurray (Former Name)
Practice location
825 June StFremont, OH 43420-3417
Phone 567-280-4531
Mailing address
825 June StFremont, OH 43420-3417
Phone 567-280-4531
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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