Individual provider · Type 1 NPI

Travon Di Angelo Tillis

Mental Health Counselor · South Pasadena, CA

NPI number 1740407576 Active

Practice location

625 Fair Oaks Ave, 300
South Pasadena, CA 91030-2630

Call (626) 395-7100 Map

Mailing address

333 S Beaudry Ave
Los Angeles, CA 90017-1466

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700XNone listed
Rehabilitation Practitioner 225400000XNone listed
Mental Health Counselor Primary 101YM0800XASW104373 (CA)

Mental Health Counselor: Definition to come...

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About NPI 1740407576

Travon Di Angelo Tillis's National Provider Identifier is 1740407576, issued on Apr 20, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in South Pasadena, CA. The record was last updated on Sep 11, 2023.