Healthcare Provider Details

I. General information

NPI: 1346132404
Provider Name (Legal Business Name): THE LILY CENTER, LCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 EDNAM DR STE 215
CHARLOTTESVILLE VA
22903-4625
US

IV. Provider business mailing address

1822 EDGEWOOD LN
CHARLOTTESVILLE VA
22903-1603
US

V. Phone/Fax

Practice location:
  • Phone: 434-207-2219
  • Fax:
Mailing address:
  • Phone: 434-207-2219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LILLIAN GUMZ JOSEPH
Title or Position: OWNER
Credential: LCSW
Phone: 434-207-2219