Rene Stephan Tillich, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY55 Issued in HI

Practice address

446 Kawaihae St Apt 119
Honolulu, HI 96825-5202

Phone

(808) 394-2800

Fax

(562) 245-6419

NPI assigned

Sep 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Clinical & Counseling Psychology

  • Clinical Psychologist
  • Honolulu, HI
  • NPI 1770755811
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1760585137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 KAWAIHAE ST APT 119",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968255202",
            "telephone_number": "808-394-2800",
            "fax_number": "562-245-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 KAWAIHAE ST APT 119",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968255202",
            "telephone_number": "808-394-2800",
            "fax_number": "562-245-6419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 Kalanianaole Hwy",
            "address_2": "#225",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968251281",
            "country_code": "US",
            "telephone_number": "808-394-2800",
            "fax_number": "808-394-2826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLICH",
        "first_name": "RENE",
        "middle_name": "STEPHAN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY55",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "56622",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUEENS HEALTH CARE PLAN",
            "identifier": "PSY55",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffe, LLC
• Tiger Lily Psychiatry and Wellness, LLC
• Sergei Tikhonenkov, MD
• Kelli Till, MA, CCC-SLP
• Joan Columbia Tillich, LCSW
• Erin Tillman, MA, ATC
• Mulimuli Tilo
• Sara Tilton
• Patrice M. L. Tim Sing, MD
• Enrico Deleon Timario

• Clinical Psychologist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.