Tier1 Performance Coach

Primary specialty

Exercise & Sports PsychologistTaxonomy code 103TE1100X

Legal business name

TIER1 PERFORMANCE COACH

Practice address

347 Jessica Dr
Middletown, DE 19709-4013

Phone

(302) 357-0029

NPI assigned

Jan 28, 2021

Organization subpart

No

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

Authorized official

Name

Justin Tillinghast, PHD

Title

Mental Performance Coach

Phone

(302) 357-0029

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1982295358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 JESSICA DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197094013",
            "telephone_number": "302-357-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 JESSICA DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197094013",
            "telephone_number": "302-357-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIER1 PERFORMANCE COACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "TILLINGHAST",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "MENTAL PERFORMANCE COACH",
        "authorized_official_telephone_number": "302-357-0029",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TE1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Exercise & Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Tier1performancecoach.com",
            "affiliation": "N",
            "address_1": "347 Jessica Dr",
            "city": "Middletown",
            "state": "DE",
            "country_code": "US",
            "postal_code": "197094013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychologist in Middletown, DE
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.