Individual provider · Type 1 NPI

David Roger Tillis, LPC, NCC, MAC

Professional Counselor · Johns Creek, GA

NPI number 1114159696 Active

Practice location

9635 Ventana Way, Suite 101
Johns Creek, GA 30022-8620

Call (770) 495-6339 Map

Fax (770) 495-6338

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XMAC030853 (GA)
Professional Counselor Primary 101YP2500XLPC001626 (GA)

Professional Counselor: Definition to come...

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About NPI 1114159696

David Roger Tillis, LPC, NCC, MAC's National Provider Identifier is 1114159696, issued on Aug 17, 2009. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Johns Creek, GA. The record was last updated on Aug 17, 2009.