Healthcare Provider Details

I. General information

NPI: 1497541452
Provider Name (Legal Business Name): LILLI SEELEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 ANDOVER RD
WESTBROOK ME
04092-3848
US

IV. Provider business mailing address

844 STATE ST APT 57
BANGOR ME
04401-5684
US

V. Phone/Fax

Practice location:
  • Phone: 207-661-6157
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC24844
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: