MR. JEREMY C TILLACK CDCA
NPI 1447176508
Counselor in Marion, OH
- Individual
- Male
- Counselor
About JEREMY TILLACK
This page provides the complete NPI Profile along with additional information for Jeremy Tillack, a provider established in Marion, Ohio with a medical specialization in Counselor. The healthcare provider is registered in the NPI registry with number 1447176508 assigned on June 2026. The practitioner's primary taxonomy code is 101Y00000X with license number 190323 (OH). The provider is registered as an individual and his NPI record was last updated June 2026.
- NPI
- 1447176508 Verify this NPI
- Provider Name
- MR. JEREMY C TILLACK CDCA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 152 OAK ST MARION, OH 43302
- Location Phone
- (567) 409-1989
- Mailing Address
- 152 OAK ST MARION, OH 43302
- Mailing Phone
- (567) 409-1989
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-24-2026
- Last Update Date
- 06-24-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor
- Taxonomy Code
- 101Y00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 190323
- License State
- OH
- Taxonomy Description
- A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1447176508, enumerated as an "individual" on June 24, 2026.
The provider is located at 152 OAK ST MARION, OH 43302 and the phone number is (567) 409-1989.
Counselor with taxonomy code 101Y00000X.
