Provider Demographics
NPI:1871683292
Name:TILTON-SMITH, SYLVIA L (MSN, APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:L
Last Name:TILTON-SMITH
Suffix:
Gender:F
Credentials:MSN, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WESSEL DR STE 2C
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-3674
Mailing Address - Country:US
Mailing Address - Phone:513-333-5800
Mailing Address - Fax:513-741-4731
Practice Address - Street 1:500 WESSEL DR STE 2C
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-3674
Practice Address - Country:US
Practice Address - Phone:513-333-5800
Practice Address - Fax:513-741-4731
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS-02212101YM0800X
OHRN 134560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNS02281Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION N
OHP67067Medicare UPIN