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

Tiffany Statham, LCSW

Individual provider Clinical Social Worker · NPI 1669808317

Tiffany Statham, LCSW is a Clinical Social Worker in Provo, Utah. Qualified in 2011, 15 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
15
Licensed in
UT
In the registry since
2013
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1034 N 500 W
Provo, UT 84604-3380
Phone: (801) 357-2068
Fax: (801) 357-7274
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 7922725-3501 (UT)

Record details

NPI number1669808317
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedSeptember 25, 2013
Last updated in NPPESSeptember 30, 2021
Certification dateSeptember 30, 2021
Mailing address1034 N 500 W, Provo, UT 84604-3380

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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