Healthcare Provider Details

I. General information

NPI: 1871115634
Provider Name (Legal Business Name): LILLIAN KERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7309 BALTIMORE AVE STE 220
COLLEGE PARK MD
20740-3200
US

IV. Provider business mailing address

7309 BALTIMORE AVE STE 220
COLLEGE PARK MD
20740-3200
US

V. Phone/Fax

Practice location:
  • Phone: 301-648-8920
  • Fax:
Mailing address:
  • Phone: 301-648-8920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30889
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200003835
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: