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General NPI Number Information
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NPI Number | 1043921760
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Entity Type | Individual
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Provider Name | LILY HANSCOM
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Gender | Female
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 899 N WILMOT RD STE B
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City | TUCSON
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State | AZ
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Zip | 85711-1712
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Country | US
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Telephone | 520-290-1100
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Fax | 520-290-8997
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | MARANA
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State | AZ
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Zip | 85653-0188
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Country | US
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Telephone | 520-290-1100
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Fax | 520-290-8997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LPC-20594
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-20594
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-20594
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License Number State | AZ
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