Larae J Ferman-Tillis, PHD,LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.0029427 Issued in OH

Practice address

1293 Copley Rd
Akron, OH 44320-2766

Phone

(216) 773-0046

NPI assigned

Oct 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Larae J Tillis Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1144530742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15408 GLENWOOD AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441373704",
            "telephone_number": "216-287-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1293 COPLEY RD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443202766",
            "telephone_number": "216-773-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERMAN-TILLIS",
        "first_name": "LARAE",
        "middle_name": "J",
        "credential": "PHD,LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.0029427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0268768",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARAE",
            "last_name": "TILLIS",
            "middle_name": "J",
            "credential": "PHD, LSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jacqueline Ferguson, RN
• Laura Hays Ferguson, MD
• Rachel Lee Ferguson, DPT
• Xandra Ferguson
• Ruthann Ferik, CNP
• Chadwick Fernanders
• Christina Marie Ferra, APRN-CPNP
• Justin Ferrel, M.D.
• Alicia Marie Ferrell, RD
• James Ferrell, PHARMD

• Clinical Social Worker in Akron, OH
• Providers in Akron, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.