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.

NPI 1851618391Rochester, NYClinical Social Worker

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
Taxonomies
Clinical Social Worker (1041C0700X), Social Worker (104100000X)