Provider Demographics
NPI:1427520931
Name:TILLERY TIME CONSULTING
Entity type:Organization
Organization Name:TILLERY TIME CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-393-2541
Mailing Address - Street 1:512 E 9TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2679
Mailing Address - Country:US
Mailing Address - Phone:785-393-2541
Mailing Address - Fax:888-959-7694
Practice Address - Street 1:512 E 9TH ST STE B
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2679
Practice Address - Country:US
Practice Address - Phone:785-992-4034
Practice Address - Fax:888-959-7694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-21
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201107170AMedicaid