| Doctor Name: | MR. JEROME EDWARD TILGHMAN |
| NPI Number: | 1184830275 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC, CAC II |
| License Number: | 14051313 |
| Business Practice Address: | 337 E Main St Ste B Moncks Corner, SC - 294615735 |
| Business Phone Number: | 8433642321 |
| Business Fax Number: | 8009486030 |
| Mailing Address: | Po Box 474, MONCKS CORNER |
| State: | SC |
| Postal Code: | 294610474 |
| Phone Number: | 8433642321 |
| Fax Number: | 8009486030 |
| NPI Enumeration Date: | 05/15/2007 |
| NPI Last Update Date: | 10/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 14051313 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |