Healthcare Provider Details

I. General information

NPI: 1124048731
Provider Name (Legal Business Name): LILLIAN R. STRUCKUS MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 01/11/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 NORTH MAIN STREET VA MEDICAL CENTER
LEEDS MA
01053-9764
US

IV. Provider business mailing address

118 OAK ST APT. #25
FLORENCE MA
01062-1372
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-4040
  • Fax: 413-582-3082
Mailing address:
  • Phone: 413-585-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101929
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: