MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP) – Clinical Social Worker, NPI 1114389301

MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP) is a healthcare provider. based in Lansing, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW, CAADC, SAP. They hold a License No. C-03445 (MI). The NPI Number for MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP) is 1114389301

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP)
NPI
1114389301
Phone
(517) 515-6176
Address
3721 W MICHIGAN AVE STE 200
Enumeration Date
25 March 2016
Last Update Date
21 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5175156176
Graduation Year
2016 (10 years ago)
PAC ID
4587911755
Group Practice PAC ID
1355854209
Professional Enrollment ID
I20180718003493
Address ID
MI489173600LA3721XAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:10State licenses:2Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

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Provider Addresses for MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP)

  • West Michigan Avenue, Downtown, Lansing, Ingham County, Michigan, 48933, United States

    LANSING, MI 489173600

    Phone: (517) 515-6176

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-07-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180718003493IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48917)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355854209View full group profile
NameSpecialtyState
Clinical Social WorkerMI

Reviews

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Frequently asked questions

What is the registry number for MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP)?
The registry entry for MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP) shows NPI 1114389301.
Should I treat MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP) as an active provider?
Patients and plans typically see MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP) as active in the national extract.
What services align with MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP)'s listing?
MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP)?
MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP) is associated with Lansing, Michigan in the same public data insurers reference.
Can I export MRS. CANDACE LYNN TILLERY (LMSW, CAADC, SAP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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