Basic Information
| Provider Information | |||||||||
| NPI: | 1568677433 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAHLMAN | ||||||||
| FirstName: | TIFANNIE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 745 W MOANA LN | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895094932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753343033 | ||||||||
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| Practice Location | |||||||||
| Address1: | 495 APPLE ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895023527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758272400 | ||||||||
| FaxNumber: | 7758272488 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2007 | ||||||||
| LastUpdateDate: | 03/15/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 4821-S | NV | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | IC-466 | NV | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 5592-C | NV | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 1184029464 | 01 | GROUP NPI | OTHER |