Mallory Tiffany, LMHC, LPC
Counselor, Mental Health in St Petersburg, FL. Individual provider (NPI-1).
NPI number1982251633
StatusActive
Last updated in NPPESMay 6, 2026
Details
- NPI
- 1982251633
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Mallory Tiffany
- Credential
- LMHC, LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 19, 2019
- Certification date
- May 6, 2026
- Last updated
- May 6, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | MH20318 | FL | Yes |
| 101YP2500X | Counselor, Professional | 2023030592 | MO |
Other names
- Mallory Diaz (Former Name)
Practice location
7901 4th St N # 12833St Petersburg, FL 33702-4305
Phone 813-658-8985
Mailing address
7901 4th St N # 12833St Petersburg, FL 33702-4305
Phone 813-658-8985
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