David Roger Tillis, LPC, NCC, MAC

Professional Counselor · Johns Creek, GA

Individual Active NPI

NPI number 1114159696

Practice location

9635 Ventana Way
Suite 101
Johns Creek, GA 30022-8620
Phone
(770) 495-6339
Fax
(770) 495-6338

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NPI record

NPI
1114159696
Entity type
Individual (Type 1)
Enumeration date
August 17, 2009
Last updated
August 17, 2009
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Professional Counselor Primary 101YP2500X LPC001626 GA
Addiction (Substance Use Disorder) Counselor 101YA0400X MAC030853 GA

About David Tillis

David Roger Tillis, LPC, NCC, MAC is a healthcare provider registered in the NPI registry with the primary taxonomy Professional Counselor (code 101YP2500X). The practice location is 9635 Ventana Way, Suite 101, Johns Creek, GA 30022-8620. The NPI number 1114159696 was assigned on August 17, 2009 and the record was last updated on August 17, 2009.

David Tillis lists 2 licenses in the registry: #LPC001626 (GA) for Professional Counselor; #MAC030853 (GA) for Addiction (Substance Use Disorder) Counselor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of David Roger Tillis, LPC, NCC, MAC?

The NPI number is 1114159696.

What is the phone number of David Tillis?

The phone number listed for the practice location is (770) 495-6339.

Where is David Tillis located?

9635 Ventana Way, Suite 101, Johns Creek, GA 30022-8620.

What is the taxonomy code for David Tillis?

The primary taxonomy code is 101YP2500X – Professional Counselor; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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