| Doctor Name: | MR. CHARLES EDWIN TIFT |
| NPI Number: | 1194706887 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMSW, NCAC II, CCS |
| License Number: | 012789 |
| Business Practice Address: | 210 Garden Cir Hinesville, GA - 313134421 |
| Business Phone Number: | 9129774663 |
| Business Fax Number: | 9123696530 |
| Mailing Address: | 36 Coates Rd, HINESVILLE |
| State: | GA |
| Postal Code: | 313131013 |
| Phone Number: | 9123695973 |
| Fax Number: | 9123696530 |
| NPI Enumeration Date: | 11/09/2005 |
| NPI Last Update Date: | 08/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 012789 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |