Active NPI
Chad E Tillbrook, PH.D.
- Clinical Psychologist
- Worcester, MA
National Provider Identifier
1275630345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 8097
- Practice address
- 55 Lake Ave N
Umms, Dept. of Psychiatry (WSH-6B)
Worcester, MA 01655-0002 - Phone
- (508) 856-6580
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8097 | MA | Primary |
| Forensic Psychologist | 103TF0200X | 8097 | MA |
Addresses
Primary practice location
55 Lake Ave N
Umms, Dept. of Psychiatry (WSH-6B)
Worcester, MA 01655-0002
Mailing address
55 Lake Ave N
Umms, Dept. of Psychiatry (WSH-6B)
Worcester, MA 01655-0002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8097 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1275630345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"address_2": "UMMS, DEPT. OF PSYCHIATRY (WSH-6B)",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"address_2": "UMMS, DEPT. OF PSYCHIATRY (WSH-6B)",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-856-6580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLBROOK",
"first_name": "CHAD",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "8097",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "MA",
"license": "8097",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.