Individual provider Active NPI

Tiphani Fillingim

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1770096190
Registry record updated Dec 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008373A Issued in IN
Practice address
1010 S Weinbach Ave
Evansville, IN 47714-2934
Phone
(812) 602-4022
NPI assigned
Nov 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34008373A IN Primary

Addresses

Primary practice location

1010 S Weinbach Ave
Evansville, IN 47714-2934

Mailing address

1010 S Weinbach Ave
Evansville, IN 47714-2934
Phone (812) 602-4022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34008373AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Illuminating Hope Counseling, LLC Clinical Current Accepting new patients
Safe Haven LLC Clinical PastSince Dec 21, 2018 Accepting new patients

Locations

4088 State Route 261
Newburgh, IN 47630
Phone (812) 221-3881

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1770096190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 S WEINBACH AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477142934",
            "telephone_number": "812-602-4022",
            "fax_number": "912-602-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S WEINBACH AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477142934",
            "telephone_number": "812-602-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLINGIM",
        "first_name": "TIPHANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008373A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; 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.