Individual
MRS. CANDACE LYNN TILLERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, CAADC, SAP
Contact information
Practice address
3721 W MICHIGAN AVE STE 200, LANSING, MI 48917-3600
(517) 515-6176
(517) 515-6176
Mailing address
3721 W MICHIGAN AVE STE 200, LANSING, MI 48917-3600
(517) 515-6176
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-03445
MI
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
6801099467
MI
Other
Enumeration date
03/25/2016
Last updated
03/21/2024
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