Provider Demographics
NPI:1295350908
Name:TILBURY, HEATHER KIRSTEN (LCSW-S; RPT-S)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:KIRSTEN
Last Name:TILBURY
Suffix:
Gender:F
Credentials:LCSW-S; RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-1017
Mailing Address - Country:US
Mailing Address - Phone:281-944-5740
Mailing Address - Fax:
Practice Address - Street 1:1005 E 27TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-1017
Practice Address - Country:US
Practice Address - Phone:281-944-5740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical