Willowdean Tiller, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH6007 Issued in FL

Practice address

801 Jenks Ave
Suite C
Panama City, FL 32401-2576

Phone

(850) 640-1020

Fax

(850) 640-1022

NPI assigned

Oct 27, 2005

Last updated

Jun 30, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Willowdean D. Tiller, Inc.

  dba Accolade Counseling

  • Community/Behavioral Health Agency
  • Panama City, FL
  • NPI 1730486663
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1033109350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 JENKS AVE",
            "address_2": "SUITE C",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012576",
            "telephone_number": "850-640-1020",
            "fax_number": "850-640-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 JENKS AVE",
            "address_2": "SUITE C",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012576",
            "telephone_number": "850-640-1020",
            "fax_number": "850-640-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "WILLOWDEAN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "984",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "762242200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Three Little Birds Therapy
• Meredith Finch Thurlow, L.C.S.W.
• Sean Patrick Tierney, LMT
• Nancy Tilghman, SLP
• Sarabia J Tiller
• Tim M Smith, M.D.
• Edem Nguamon Timpo, MD
• Yolanda M Tingler, LCSW
• Gloria S Tipton, ED.D., M.S.W.
• Virginia H Tochterman

• Mental Health Counselor in Panama City, FL
• Providers in Panama City, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.