Tillman, Gina Marie

Tillman, Gina Marie is an sole proprietor health care provider with primary practice located at 1808 Orchid St , Sarasota FL 34239-5131. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Tillman, Gina Marie can be contacted via phone (941) 313-7040.

Contact Information

Primary practice address
1808 Orchid St Sarasota FL 34239-5131
Phone: (941) 313-7040
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 00076724 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW12758 Florida
Behavioral Health & Social Service Providers / Clinical 1041C0700X 080483 New York

Profile Details

NPI number 1649428061
LBN Legal business name Tillman, Gina Marie
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 28th, 2008
Last updated Sep 7th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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