Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Johnny Lawrence Tillis

Individual provider Counselor · NPI 1528606829

Johnny Lawrence Tillis is a Counselor in Elk Grove, California. Works from 2 locations. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2
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Practice location Address checks out

9412 Big Horn Blvd Ste 6
Elk Grove, CA 95758-1101
Phone: (916) 879-2574
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9343 Tech Center Dr, Sacramento, CA 95826-2563 — (916) 531-2822

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Counselor Taxonomy 101Y00000X

Record details

NPI number1528606829
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 17, 2019
Last updated in NPPESSeptember 20, 2021
Certification dateSeptember 20, 2021
Mailing address9412 Big Horn Blvd Ste 6, Elk Grove, CA 95758-1101

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