National Provider Identifier
Khadijah Ella Tillman, LCSW-R
Khadijah Ella Tillman, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Rochester, NY and a listed phone number of (585) 713-2071.
Source: public NPPES record, last updated April 19, 2017. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1851618391
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- April 23, 2010
- Last Updated
- April 19, 2017
Practice Location
- 4 Chelmsford RD.
- Rochester, NY 14609
Phone: (585) 713-2071
Specialties
- Clinical Social Worker (1041C0700X)
- Social Worker (104100000X)
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Full Record
- NPI
- 1851618391
- Entity Type
- Individual
- Last Name
- Tillman
- First Name
- Khadijah
- Middle Name
- Ella
- Credential
- LCSW-R
- Mailing Street Address
- 4 Chelmsford RD.
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14609
- Mailing Country
- US
- Mailing Phone
- (585) 713-2071
- Practice Street Address
- 4 Chelmsford RD.
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14609
- Practice Country
- US
- Practice Phone
- (585) 713-2071
- Enumeration Date
- April 23, 2010
- Last Updated
- April 19, 2017
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X), Social Worker (104100000X)