Provider Demographics
NPI:1295605327
Name:TILLEY, LYNDZEE (CRC, LCMHC-A)
Entity type:Individual
Prefix:
First Name:LYNDZEE
Middle Name:
Last Name:TILLEY
Suffix:
Gender:F
Credentials:CRC, LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MOSSYCUP LOOP APT 203
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4195
Mailing Address - Country:US
Mailing Address - Phone:919-972-1894
Mailing Address - Fax:
Practice Address - Street 1:3080 HAMMOND BUSINESS PL STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3666
Practice Address - Country:US
Practice Address - Phone:919-664-1233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21578101YM0800X
NC630969101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor