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NPI Code Detail

MEDICARE: LYNDSEY M KILLILEA LICSW

MEDICARE: LYNDSEY M KILLILEA LICSW
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
11041C0700XClinical Social Worker699884MA

General Provider Information

NPI Number : 1841502085
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNDSEY M KILLILEA LICSW
Provider Business Mailing Address
First Line : 201 CHELMSFORD ST
Second Line :
City : CHELMSFORD
State : MA
Zip : 01824-2359
Country : US
Telephone Number : 978-256-1467
Fax Number :
Provider Business Practice Location Address
First Line : 201 CHELMSFORD ST
Second Line :
City : CHELMSFORD
State : MA
Zip : 01824-2359
Country : US
Telephone Number : 978-256-1467
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2010
Last Update Date : 04/14/2015

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Directions to “ LYNDSEY M KILLILEA LICSW” Practice Location

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