Individual provider Active NPI

Timothy Glen Hillyer, MSW, LCSW, LISW

  • Social Worker
  • Moline, IL
National Provider Identifier
1255710950
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150013100 Issued in IL
Practice address
1465 41St St Ste 6
Moline, IL 61265-2579
Phone
(309) 232-8669
Fax
(309) 326-4521
NPI assigned
May 27, 2015
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150013100 IL Primary
Clinical Social Worker 1041C0700X SW17734 FL

Addresses

Primary practice location

1465 41St St Ste 6
Moline, IL 61265-2579

Mailing address

135 Cypress Way E
Apt C
Naples, FL 34110-9288
Phone (309) 779-8397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240730004362 IL Practitioner - Clinical Social Worker 8022555721 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150013100ILMDSocial Worker
SW17734FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pulse Counseling & Wellness Center PLLC CurrentSince Jul 15, 2024 Accepting new patients

Locations

1465 41st St
Ste 6
Moline, IL 61265
Phone (309) 232-8669

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1255710950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 CYPRESS WAY E",
            "address_2": "APT C",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341109288",
            "telephone_number": "309-779-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 41ST ST STE 6",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612652579",
            "telephone_number": "309-232-8669",
            "fax_number": "309-326-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLYER",
        "first_name": "TIMOTHY",
        "middle_name": "GLEN",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW, LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150013100",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17734",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.