Provider Demographics
NPI:1174216378
Name:TILFORD, THOMAS HUGH (LCSW)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:HUGH
Last Name:TILFORD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-6022
Mailing Address - Country:US
Mailing Address - Phone:775-293-3997
Mailing Address - Fax:325-659-7464
Practice Address - Street 1:2018 PULLIAM ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76905-5148
Practice Address - Country:US
Practice Address - Phone:325-659-7270
Practice Address - Fax:325-659-7464
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1035291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical