MEDICARE: LILLIE COUNSELING AND CONSULTING

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1174193098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LILLIE COUNSELING AND CONSULTING

Provider Business Mailing Address
First Line	:	28 DALLAS ST
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-3025
Country	:	US
Telephone Number	:	828-335-9876
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 DALLAS ST
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-3025
Country	:	US
Telephone Number	:	828-335-9876
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA LILLIE
Credential	:
Telephone Number	:	828-335-9876

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	07/01/2021

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