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General NPI Number Information
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NPI Number | 1205982444
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Entity Type | Individual
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Provider Name | PATRICIA ELIZABETH LILLY B.S, CCDC, CPC-AD
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Gender | Female
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Dates
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Enumeration Date | 01/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 260 GATEWAY DR SUITE 18A
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City | BEL AIR
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State | MD
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Zip | 21014-4268
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Country | US
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Telephone | 410-893-3896
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Fax | 410-893-3896
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Provider Business Mailing Address
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Address Line | 2112 HAMPTON CT
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City | FALLSTON
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State | MD
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Zip | 21047-2022
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Country | US
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Telephone | 410-893-3896
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Fax | 410-877-2936
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | AC0032
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License Number State | MD
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