Provider Demographics
NPI:1831907500
Name:TILLMAN, CHANTAY (CHAPLAIN)
Entity type:Individual
Prefix:MS
First Name:CHANTAY
Middle Name:
Last Name:TILLMAN
Suffix:
Gender:F
Credentials:CHAPLAIN
Other - Prefix:
Other - First Name:CHANTAY
Other - Middle Name:D
Other - Last Name:TILLMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CHAPLAIN
Mailing Address - Street 1:1515 MATAGORDA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-2837
Mailing Address - Country:US
Mailing Address - Phone:214-417-3235
Mailing Address - Fax:214-258-6878
Practice Address - Street 1:7151 LIBRARY LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-3827
Practice Address - Country:US
Practice Address - Phone:214-670-1947
Practice Address - Fax:214-258-6878
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No172A00000XOther Service ProvidersDriver
No172V00000XOther Service ProvidersCommunity Health Worker
No174200000XOther Service ProvidersMeals
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175M00000XOther Service ProvidersMidwife, Lay
No251G00000XAgenciesHospice Care, Community Based
No251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No374700000XNursing Service Related ProvidersTechnician
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel
No385H00000XRespite Care FacilityRespite Care