Provider Demographics
NPI:1407459316
Name:TILLMAN, CATHERINE JOSEPHINE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:JOSEPHINE
Last Name:TILLMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:CATHY
Other - Middle Name:JOSEPHINE
Other - Last Name:TILLMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9200 NW 36TH PL STE A-4
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-3530
Mailing Address - Country:US
Mailing Address - Phone:352-200-2856
Mailing Address - Fax:
Practice Address - Street 1:9200 NW 36TH PL STE A-4
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-3530
Practice Address - Country:US
Practice Address - Phone:352-474-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-21
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21492.101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health