TIFFANY GULLORD (LICSW) – Clinical Social Worker, NPI 1881313526

TIFFANY GULLORD (LICSW) is a healthcare provider. based in Fairmont, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 20666 (MN). The NPI Number for TIFFANY GULLORD (LICSW) is 1881313526

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
TIFFANY GULLORD (LICSW)
NPI
1881313526
Phone
(507) 238-8100
Address
800 MEDICAL CENTER DR
Enumeration Date
25 August 2022
Last Update Date
23 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5076254031
Graduation Year
2012 (14 years ago)
PAC ID
9931585387
Group Practice PAC ID
4688585771
Professional Enrollment ID
I20221007001990
Address ID
MN560014752MA1025XSTXX300
Telehealth
Yes

Contacts

Secure Messaging
tgullord1695918@ehrdirect.mayoclinicmsg.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Other namesUpdated within 12 months

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for TIFFANY GULLORD (LICSW)

  • 800 MEDICAL CENTER DR

    FAIRMONT, MN 560314575

    Phone: (507) 238-8100

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-10-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221007001990IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56031)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688585771View full group profile
NameSpecialtyState
Nurse PractitionerTN
Family PracticeMN
-MN
-MN
Certified Registered Nurse Anesthetist (Crna)MN
Family PracticeMN
Internal MedicineONTARIO
Nurse PractitionerMN
Family PracticeMN
Family PracticeAR

Reviews

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Frequently asked questions

Is TIFFANY GULLORD (LICSW) listed with a National Provider Identifier?
Yes — TIFFANY GULLORD (LICSW) has NPI 1881313526 on file in the registry.
Is there an active status for TIFFANY GULLORD (LICSW)?
For scheduling context, TIFFANY GULLORD (LICSW) is shown as active in the registry.
What clinical focus is listed for TIFFANY GULLORD (LICSW)?
At a glance, TIFFANY GULLORD (LICSW) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for TIFFANY GULLORD (LICSW)?
Travel planning: use Fairmont, Minnesota as the reference point for TIFFANY GULLORD (LICSW), then confirm.
When was this NPI issued?
Enumeration for TIFFANY GULLORD (LICSW) is noted as August 25, 2022 where the registry provides it.

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