Active NPI
Emily Lauren Tilstra-Ferrell, PH.D.
- Clinical Psychologist
- Charleston, SC
National Provider Identifier
1871156745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1858
- Practice address
- 171 Ashley Ave
Charleston, SC 29425-3834 - Phone
- (843) 792-1414
- NPI assigned
- Apr 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 1858 | SC | Primary |
Addresses
Primary practice location
171 Ashley Ave
Charleston, SC 29425-3834
Mailing address
67 President St
Charleston, SC 29425-5712
Phone (843) 792-8209
Other practice location 1
300 Psychology Building Bowling Green State University
Bowling Green, OH 43403-0001
Phone (419) 372-2540
Other names 1
- Emily Lauren Ferrell
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716508800000",
"number": "1871156745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 PRESIDENT ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294255712",
"telephone_number": "843-792-8209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294253834",
"telephone_number": "843-792-1414"
}
],
"practiceLocations": [
{
"address_1": "300 Psychology Building Bowling Green State University",
"address_purpose": "LOCATION",
"city": "Bowling Green",
"state": "OH",
"postal_code": "434030001",
"country_code": "US",
"telephone_number": "419-372-2540",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TILSTRA-FERRELL",
"first_name": "EMILY",
"middle_name": "LAUREN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-17",
"last_updated": "2024-05-24",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "1858",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "FERRELL",
"middle_name": "LAUREN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.