Anna Tillery, MA, BCBA, LPA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

5446 Issued in NC

Practice address

647 Brawley School Rd Ste 104
Mooresville, NC 28117-6876

Phone

(704) 703-8588

NPI assigned

Oct 19, 2018

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tillery Psychological Services, PLLC

  • Psychologist
  • Cary, NC
  • NPI 1700603396

  Behavior Analyst

  NPD Authorized official
• Abc of NC Child Development Center

  • Early Intervention Provider Agency
  • Winston Salem, NC
  • NPI 1922277417

  Behavior Analyst

  NPD (past)
• Highlights Healthcare, LLC

  dba Highlights Healthcare

  • Community/Behavioral Health Agency
  • Mooresville, NC
  • NPI 1366047474
  NPD (past)
• Complete Rehabilitation and Sports Physical Therapy, PC

  • Physical Therapist
  • Ronkonkoma, NY
  • NPI 1811097306
  NPD (past)

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1649746413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 DENADA PATH",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076039",
            "telephone_number": "336-317-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 BRAWLEY SCHOOL RD STE 104",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176876",
            "telephone_number": "704-703-8588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8801 Fast Park Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276174853",
            "country_code": "US",
            "telephone_number": "704-703-8588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 Commerce Centre Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280785870",
            "country_code": "US",
            "telephone_number": "704-703-8588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "ANNA",
        "credential": "MA, BCBA, LPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "5446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Joan Thurman, PHARM.D
• Tynette Marie Thurston
• Tidal Sports Rehab & Recovery LLC
• Angela Mary Tidwell, OT
• Christine Tiede, MSW, LCSW-A
• Elizabeth Ellen Tilt, M.D.
• Heather Tinkham, OTR/L
• Carolann Tokarz, DPT
• Eden Toledano
• Nicole Tomlinson Vanness, LICENSED ATC

• Psychologist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.