Provider Demographics
NPI:1598067852
Name:TILFORD, JENNY ELIEEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JENNY
Middle Name:ELIEEN
Last Name:TILFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SPARGER SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1769
Mailing Address - Country:US
Mailing Address - Phone:919-491-2869
Mailing Address - Fax:
Practice Address - Street 1:200 N GREENSBORO ST STE C6
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1849
Practice Address - Country:US
Practice Address - Phone:919-962-5133
Practice Address - Fax:919-445-0414
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0070401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical