Healthcare Provider Details

I. General information

NPI: 1801712153
Provider Name (Legal Business Name): SCHOOL PSYCHOLOGIST SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 OLD THAYER MILL RD
TROY NC
27371-2009
US

IV. Provider business mailing address

222 OLD THAYER MILL RD
TROY NC
27371-2009
US

V. Phone/Fax

Practice location:
  • Phone: 910-282-7927
  • Fax:
Mailing address:
  • Phone: 910-282-7927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MARTHA ELIZABETH TILLEY
Title or Position: MEMBER AND ORGANIZER
Credential: MA, SSP, LPA
Phone: 910-282-7927