Michael George Till, PH.D., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2007033658 Issued in MO

Practice address

17844 E 23Rd St S
Independence, MO 64057-1840

Phone

(816) 254-3652

Fax

(816) 254-9243

NPI assigned

Sep 29, 2008

Last updated

Jul 8, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meridian Professional Psychological ConsultantsGroup PAC ID 5193880284, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Meridian Professional Psychological Consultants

  • Psychiatry Physician
  • East Lansing, MI
  • NPI 1225150139

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1528218328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17844 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571840",
            "telephone_number": "816-254-3652",
            "fax_number": "816-254-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17844 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571840",
            "telephone_number": "816-254-3652",
            "fax_number": "816-254-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILL",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2008004864",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2007033658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Thorp, DPT
• Alanna Thrun, RN
• Jill Tibke, N.P.
• Heather Tice, LCSW, LSCSW
• Molly J Ticknor, MA, ATR, LPC
• Tiffany N. Tiller, O.D.
• Alyssa Tims
• Chanta S Tinney, LMSW
• Kathleen Tisdale, OTR/L
• Rebecca Ann Titus, F.N.P.

• Clinical Social Worker in Independence, MO
• Providers in Independence, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.