MEDICARE: SARAH LILLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101200000X	Drama Therapist
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1700718996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH LILLEY

Provider Business Mailing Address
First Line	:	1430 MASSACHUSETTS AVE STE BANDA
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-3831
Country	:	US
Telephone Number	:	617-539-6517
Fax Number	:

Provider Business Practice Location Address
First Line	:	1430 MASSACHUSETTS AVE STE BANDA
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-3831
Country	:	US
Telephone Number	:	617-539-6517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ SARAH LILLEY ” Practice Location

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