Provider Demographics
NPI:1790784940
Name:FEELER, TILGHMAN J (LPC)
Entity Type:Individual
Prefix:DR
First Name:TILGHMAN
Middle Name:J
Last Name:FEELER
Suffix:
Gender:M
Credentials:LPC
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 71
Mailing Address - Street 2:
Mailing Address - City:KENNETT
Mailing Address - State:MO
Mailing Address - Zip Code:63857-0071
Mailing Address - Country:US
Mailing Address - Phone:573-333-5875
Mailing Address - Fax:573-333-5876
Practice Address - Street 1:925 STATE ROUTE VV
Practice Address - Street 2:
Practice Address - City:KENNETT
Practice Address - State:MO
Practice Address - Zip Code:63857-3822
Practice Address - Country:US
Practice Address - Phone:573-333-5875
Practice Address - Fax:573-333-5876
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional