Provider Demographics
NPI:1407280464
Name:TILLINGHAST, REBECCA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TILLINGHAST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 182
Mailing Address - Street 2:
Mailing Address - City:SOUTH EGREMONT
Mailing Address - State:MA
Mailing Address - Zip Code:01258-0182
Mailing Address - Country:US
Mailing Address - Phone:413-429-1474
Mailing Address - Fax:
Practice Address - Street 1:16 SHEFFIELD ROAD
Practice Address - Street 2:
Practice Address - City:SOUTH EGREMONT
Practice Address - State:MA
Practice Address - Zip Code:01258
Practice Address - Country:US
Practice Address - Phone:413-429-1474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor