Executive Counseling of Tega Cay, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

EXECUTIVE COUNSELING OF TEGA CAY, LLC

Practice address

3921 Caliper PL
Fort Mill, SC 29708-8380

Phone

(803) 487-6837

NPI assigned

Dec 28, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Mildred Bennett Tillman, LCMHC-S, LPCNPI 1467898221

Title

Owner, Clinical Director

Phone

(704) 388-2710

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mildred Bennett Tillman, LCMHC-S,LPC

  • Mental Health Counselor
  • Fort Mill, SC
  • NPI 1467898221
  NPD Authorized official

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1386357994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 CALIPER PL",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088380",
            "telephone_number": "704-388-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 CALIPER PL",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088380",
            "telephone_number": "803-487-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE COUNSELING OF TEGA CAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-28",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_middle_name": "BENNETT",
        "authorized_official_title_or_position": "OWNER, CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "704-388-2710",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCMHC-S, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Najmeh Sadat Esmaeilnejadganji, DMD
• Evelyn Claire Estrada, M.S., SLP
• Kathleen Evans, O.D.
• Logan Dean Evans, DC
• Melissa Jane Evans
• Lelle F Toth
• Jailah Faggart
• Ria Jakyra Faggart
• Deniel Fago, RN
• Anna Tinker Faircloth

• Professional Counselor in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.