Tillery Psychological Services, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

TILLERY PSYCHOLOGICAL SERVICES, PLLC

Practice address

15501 Weston Pkwy Ste 130
Cary, NC 27513-8641

Phone

(855) 295-3276

Fax

(888) 588-2752

NPI assigned

Sep 24, 2024

Organization subpart

No

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

Authorized official

Name

Anna Tillery, LPANPI 1649746413

Title

Psychologist

Phone

(919) 885-0810

Specialties & licenses 4

Addresses

Locations

Practitioners 1

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

• Anna Tillery, MA, BCBA, LPA

  • Psychologist
  • Mooresville, NC
  • NPI 1649746413

  Behavior Analyst

  NPD Authorized official

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1700603396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 S MAYFLOWER AVE STE 220",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910165239",
            "telephone_number": "818-241-6780",
            "fax_number": "888-588-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15501 WESTON PKWY STE 130",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138641",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20830 Torrence Chapel Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Cornelius",
            "state": "NC",
            "postal_code": "280310320",
            "country_code": "US",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Pomona Dr Ste G",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274071636",
            "country_code": "US",
            "telephone_number": "855-295-3276",
            "fax_number": "888-588-2752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TILLERY PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "TILLERY",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "919-885-0810",
        "authorized_official_credential": "LPA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Owen Benjamin Tice
• Jessica Tollefsen Tichenor, MS, CCC-SLP
• Jennifer A. Tidd, MPT
• Anne M. Till, RDN, LDN
• Caitlin Smith Tillberg
• Brittany J Tillman
• Shanna Tillman, PSY.D.
• Prudence Timberlake
• Victoria F Timm, MPT
• Timothy S. Barlow, DDS, PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.