Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Ricardo David Tillery, MBA, LMSW, ICAADC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1528380623

Mr. Ricardo David Tillery, MBA, LMSW, ICAADC is an Addiction (Substance Use Disorder) Counselor in Lansing, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2010
Specialties on file
4
What do these letters mean?
MBA — Master of Business Administration
A graduate business degree.
LMSW — Licensed Master Social Worker
A master's-level social worker, usually practising under supervision.

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Practice location Address checks out

3721 W Michigan Ave Ste 200
Lansing, MI 48917-3600
Phone: (517) 515-6176
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801094835 (MI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence C-02622 (MI)
Behavior Analyst Taxonomy 103K00000X
Social Worker Taxonomy 104100000X

Record details

NPI number1528380623
Entity typeIndividual (Type 1)
GenderMale
Credentials MBA , LMSW , ICAADC
Sole proprietorYes
NPI enumeratedFebruary 17, 2010
Last updated in NPPESSeptember 13, 2020
Certification dateSeptember 13, 2020

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