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General NPI Number Information
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NPI Number | 1093524878
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Entity Type | Organization
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Legal Business Name | LILYPAD THERAPY LLC
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 361 SIMMONS ST
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City | ERIE
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State | CO
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Zip | 80516-7201
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Country | US
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Telephone | 817-996-5664
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Fax | 817-927-7578
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Provider Business Mailing Address
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Address Line | 361 SIMMONS ST
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City | ERIE
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State | CO
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Zip | 80516-7201
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Country | US
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Telephone | 817-996-5664
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Fax | 817-927-7578
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Authorized Official
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Title or Position | OWNER
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Name | JANET M BROWN
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Credential | LCSW
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Telephone | 817-996-5664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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