Healthcare Provider Details

I. General information

NPI: 1134874704
Provider Name (Legal Business Name): CATHERINE TILLINGHAST LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE TILLINGHAST LPC

II. Dates (important events)

Enumeration Date: 02/12/2022
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 34TH ST STE 15
LUBBOCK TX
79410-2834
US

IV. Provider business mailing address

3610 34TH ST STE 15
LUBBOCK TX
79410-2834
US

V. Phone/Fax

Practice location:
  • Phone: 806-707-0111
  • Fax:
Mailing address:
  • Phone: 806-707-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number87204
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: