Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tiffany Nicole Jackson

Individual provider Mental Health Counselor · NPI 1164950630

Tiffany Nicole Jackson is a Mental Health Counselor in Lutz, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2017

Practice location Address checks out

21808 State Road 54
Lutz, FL 33549-6923
Phone: (813) 428-6100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence MH16981 (FL)

Record details

NPI number1164950630
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 30, 2017
Last updated in NPPESDecember 9, 2019
Certification dateDecember 9, 2019

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