Mary Ellen Tillotson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PST00182 Issued in RI

Practice address

15 Aspen Way
Warwick, RI 02886-5006

Phone

(401) 499-4598

NPI assigned

Aug 19, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: lifestanceheath.maryellentillotson@151046.advancedmd-direct.com

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1538535034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ASPEN WAY",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028865006",
            "telephone_number": "401-499-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ASPEN WAY",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028865006",
            "telephone_number": "401-499-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLOTSON",
        "first_name": "MARY ELLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PST00182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Tiburcio, LCSW
• Virginia Tiernan, CADC
• John Tietjen
• Laura Ann Till, MD
• Tracey Tillinghast, LICSW
• Lincoln P Tirpaeck, DO
• Taylor Tirrell, PA-C
• Emily Tolbert, LICSW
• Toll Gate Pediatrics, Inc.
• Toll Gate Radiology II, LLC

• Clinical Psychologist in Warwick, RI
• Providers in Warwick, RI by specialty
• Clinical Psychologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.