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General NPI Number Information
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NPI Number | 1487498317
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Entity Type | Individual
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Provider Name | LILLIAN J TINSLEY RMHI
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Gender | Female
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Dates
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Enumeration Date | 06/25/2024
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 533 N NOVA RD STE 114
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City | ORMOND BEACH
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State | FL
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Zip | 32174-4421
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Country | US
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Telephone | 386-227-7014
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Fax |
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Provider Business Mailing Address
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Address Line | 5311 GEORGIA PEACH AVE
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City | PORT ORANGE
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State | FL
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Zip | 32128-7534
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Country | US
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Telephone | 386-506-9591
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 720599
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 25639
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License Number State | FL
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