Mr Ricardo David Tillery, MBA, LMSW, ICAADC is a medicare enrolled "Social Worker - Clinical" provider in Lansing, Michigan. His current practice location is
3721 W Michigan Ave Ste 200, Lansing, Michigan. You can reach out to his office (for appointments etc.) via phone at
(517) 515-6176.
Mr Ricardo David Tillery is licensed to practice in Michigan (license number 6801094835) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1528380623.
Healthcare Provider's Profile
| Full Name | Mr Ricardo David Tillery |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 3721 W Michigan Ave Ste 200, Lansing, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1528380623
- Provider Enumeration Date: 02/17/2010
- Last Update Date: 09/13/2020
Medicare PECOS Information:
- PECOS PAC ID: 7214294974
- Enrollment ID: I20171205002052
Medical Identifiers
Medical identifiers for Mr Ricardo David Tillery such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528380623 | NPI | - | NPPES |
| 1396128088 | Medicaid | MI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | C-02622 (Michigan) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 6801094835 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Ricardo David Tillery is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Ricardo David Tillery, MBA, LMSW, ICAADC
3721 W Michigan Ave Ste 200,
Lansing, MI 48917-3600
Ph: (517) 515-6176 | Mr Ricardo David Tillery, MBA, LMSW, ICAADC
3721 W Michigan Ave Ste 200,
Lansing, MI 48917-3600
Ph: (517) 515-6176 |
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