KELLI TILLQUIST (NPI# 1619539947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619539947 |
| Entity Type | Individual |
| Full Name | KELLI TILLQUIST |
| Practice Address |
607 Division Street Nome AK 97762 |
| Practice Telephone | 9074433344 |
| Mailing Telephone | 9074433344 |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
607 DIVISION STREET |
| City | NOME |
| State | AK |
| Zip Code | 97762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053595371 | Seth Green | Psychologist | 607 Division Street, Nome, AK 99762-0966 | 2007-12-21 |
| 1790303451 | Cody Lind Gustaveson | Counselor | 607 Division Street, Nome, AK 99762 | 2020-07-09 |
| 1487272241 | Brooke Ann Maupin | Counselor | 607 Division Street, Nome, AK 99762 | 2020-07-08 |
| 1861018400 | Da-taryotu Joseph Egbuke | Counselor | 607 Division Street, Nome, AK 99762 | 2020-06-19 |
| 1568081263 | Scott Russell Dickinson | Preventive Medicine | 607 Division Street, Nome, AK 99762 | 2020-04-13 |
| 1780217844 | Hannah Marie Schnaidt | Counselor | 607 Division Street, Nome, AK 99762 | 2020-02-18 |
| 1578112629 | Jeffrey Lee Rose | Counselor | 607 Division Street, Nome, AK 99762-0966 | 2019-09-10 |
| 1124673645 | Colleen Dee Reynolds | Counselor | 607 Division Street, Nome, AK 99762 | 2019-08-02 |
| 1750883211 | Bertha Carol Koweluk | Counselor | 607 Division Street, Nome, AK 99762 | 2018-03-01 |
| 1346741634 | Royleen Joan Ross | Psychologist | 607 Division Street, Nome, AK 99762 | 2018-02-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720379407 | Ann Mendelson | Occupational Therapist | 23 Amos St., Jerusalem, ISRAEL 97762 | 2011-04-28 |
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030773 | Aura Chasteen | Counselor | 907 Division Street, Nome, AK 99762 | 2020-07-09 |
| 1891296489 | Yonaton Sahar Davidson | Counselor | Nome Community Center, Nome, AK 99762 | 2018-02-28 |
| 1003218538 | Jennifer L Morton | Counselor | 113 Front Street, Suire 200, Nome, AK 99762-9976 | 2014-09-16 |
| 1083838379 | Michael Joseph Walker | Counselor | 607 Division St., Nome, AK 99762 | 2007-04-11 |
| 1790303451 | Cody Lind Gustaveson | Counselor | 607 Division Street, Nome, AK 99762 | 2020-07-09 |
| 1487272241 | Brooke Ann Maupin | Counselor | 607 Division Street, Nome, AK 99762 | 2020-07-08 |
| 1467079525 | Gwendolyn Spencer Barnhart | Counselor | 607 Division St., Nome, AK 99762 | 2020-07-06 |
| 1861018400 | Da-taryotu Joseph Egbuke | Counselor | 607 Division Street, Nome, AK 99762 | 2020-06-19 |
| 1235781402 | Sharon M. Houlahan | Counselor | 607 Division St., Nome, AK 99762 | 2019-07-09 |
| 1104478379 | Sara Francesca Garavuso | Counselor | 607 Division St., Nome, AK 99762 | 2019-07-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.