Active NPI
Terrie Grace Tilotta, LPSW
- Clinical Social Worker
- Roseburg, OR
National Provider Identifier
1407198567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SC60418287
- Practice address
- 913 NW Garden Valley Blvd
VA Roseburg Healthcare System
Roseburg, OR 97471-6523 - Phone
- (541) 440-1000
- Fax
- (541) 440-1273
- NPI assigned
- Mar 26, 2013
- Sex
- Female
- Sole proprietor
- No
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 Social Worker | 1041C0700X | SC60418287 | WA | Primary |
| Clinical Social Worker | 1041C0700X | 13319 | PR |
Addresses
Primary practice location
913 NW Garden Valley Blvd
VA Roseburg Healthcare System
Roseburg, OR 97471-6523
Mailing address
913 NW Garden Valley Blvd
VA Roseburg Healthcare System
Roseburg, OR 97471-6523
Phone (541) 440-1000
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC60418287 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459987200000",
"number": "1407198567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 NW GARDEN VALLEY BLVD",
"address_2": "VA ROSEBURG HEALTHCARE SYSTEM",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974716523",
"telephone_number": "541-440-1000",
"fax_number": "541-440-1273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "913 NW GARDEN VALLEY BLVD",
"address_2": "VA ROSEBURG HEALTHCARE SYSTEM",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974716523",
"telephone_number": "541-440-1000",
"fax_number": "541-440-1273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILOTTA",
"first_name": "TERRIE",
"middle_name": "GRACE",
"name_prefix": "Mrs.",
"credential": "LPSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-26",
"last_updated": "2016-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "SC60418287",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PR",
"license": "13319",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.