Individual provider Active NPI

George Edward Tilley, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1356320790
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C003070 Issued in NC
Practice address
3117 Whiting Ave
Charlotte, NC 28205-1648
Phone
(910) 508-7400
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C003070 NC Primary

Addresses

Primary practice location

3117 Whiting Ave
Charlotte, NC 28205-1648

Mailing address

3117 Whiting Ave
Charlotte, NC 28205-1648
Phone (910) 508-7400

Other identifiers 4

IdentifierTypeStateIssuer
13006OtherNCBLUE CROSS AND BLUE SHIEL
132A0OtherNCBLUE CROSS/BLUE SHIELD
6003469MedicaidNC
6002292MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • 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
I20040608001031 NC Practitioner - Clinical Social Worker 6709869159 Practice locations: Charlotte, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3117 Whiting Ave
Charlotte, NC 28205-1648
Phone (910) 508-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C003070NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1356320790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 WHITING AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051648",
            "telephone_number": "910-508-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 WHITING AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051648",
            "telephone_number": "910-508-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "GEORGE",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "13006",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "132A0",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003469",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002292",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.