Active NPI
Guy F Tillson
- Mental Health Counselor
- Conway, NH
National Provider Identifier
1841310786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 508
- Practice address
- 25 W Main St
Conway, NH 03818-6142 - Phone
- (603) 447-2111
- NPI assigned
- Mar 31, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 508 | NH | Primary |
Addresses
Primary practice location
25 W Main St
Conway, NH 03818-6142
Mailing address
87 Washington St
Conway, NH 03818-6044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7706638Y0NH01 | Other | ANTHEM |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 508 | NH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Human Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Center Conway, NH
- NPI 1700955028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841310786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 WASHINGTON ST",
"city": "CONWAY",
"state": "NH",
"postal_code": "038186044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 W MAIN ST",
"city": "CONWAY",
"state": "NH",
"postal_code": "038186142",
"telephone_number": "603-447-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLSON",
"first_name": "GUY",
"middle_name": "F",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NH",
"license": "508",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "7706638Y0NH01",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.