Individual
TRACEY TILLINGHAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
300 TOLL GATE RD, WARWICK, RI 02886-4416
(401) 785-0040
Mailing address
300 TOLL GATE RD, WARWICK, RI 02886-4416
(401) 785-0040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02714
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GH57134
—
RI
01
—
ISW02714
DEPARTMENT OF HEALTH
RI
Enumeration date
05/26/2010
Last updated
02/17/2025
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