Provider Demographics
NPI:1316240161
Name:TILSON, VICTORIA A (LMHC)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:A
Last Name:TILSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:TORI
Other - Middle Name:A
Other - Last Name:TILSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19 SPRING TERRACE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3016
Mailing Address - Country:US
Mailing Address - Phone:413-772-8691
Mailing Address - Fax:
Practice Address - Street 1:10 FISKE AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3276
Practice Address - Country:US
Practice Address - Phone:413-772-8691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6464101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health