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NPI Code Detail

MEDICARE: LILY ANDERSON

MEDICARE: LILY ANDERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1093498404
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILY ANDERSON
Provider Business Mailing Address
First Line : 717 9TH AVE APT 2B
Second Line :
City : NEW YORK
State : NY
Zip : 10019-7389
Country : US
Telephone Number : 919-943-6122
Fax Number :
Provider Business Practice Location Address
First Line : 299 BROADWAY STE 905
Second Line :
City : NEW YORK
State : NY
Zip : 10007-1960
Country : US
Telephone Number : 917-873-1022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2023
Last Update Date : 08/11/2023

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Directions to “ LILY ANDERSON ” Practice Location

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