Mrs Gina Marie Tillman, LCSW is a
Social Worker - Clinical based in Sarasota, Florida. Mrs Gina Marie Tillman is licensed to practice in Florida (license number SW12758) and her current practice location is
1808 Orchid St, Sarasota, Florida. She can be reached at her office (for appointments etc.) via phone at
(941) 313-7040.
NPI number for Mrs Gina Marie Tillman is 1649428061 and her current mailing address is 1808 Orchid St, Sarasota, Florida. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1649428061.
Healthcare Provider's Profile
| Full Name | Mrs Gina Marie Tillman |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
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| Location | 1808 Orchid St, Sarasota, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1649428061
- Provider Enumeration Date: 08/28/2008
- Last Update Date: 09/07/2015
Medical Identifiers
Medical identifiers for Mrs Gina Marie Tillman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1649428061 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 00076724 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW12758 (Florida) | Primary |
| 1041C0700X | Social Worker - Clinical | 080483 (New York) | Secondary |
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. Mrs Gina Marie Tillman is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Gina Marie Tillman, LCSW
1808 Orchid St,
Sarasota, FL 34239-5131
Ph: (941) 313-7040 | Mrs Gina Marie Tillman, LCSW
1808 Orchid St,
Sarasota, FL 34239-5131
Ph: (941) 313-7040 |
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