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NPI Code Detail

MEDICARE: LILY SHROYER LCSW LLC

MEDICARE: LILY SHROYER LCSW LLC
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1447104880
Entity Type Code : Organization
Provider Name (Legal Business Name) : LILY SHROYER LCSW LLC
Provider Business Mailing Address
First Line : 1138 BELMONT AVE
Second Line :
City : SOUTH BEND
State : IN
Zip : 46615-1102
Country : US
Telephone Number : 574-807-4869
Fax Number :
Provider Business Practice Location Address
First Line : 1138 BELMONT AVE
Second Line :
City : SOUTH BEND
State : IN
Zip : 46615-1102
Country : US
Telephone Number : 574-807-4869
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : LILLIAN SHROYER
Credential : LCSW
Telephone Number : 574-807-4869
Provider Enumeration Date : 02/23/2026
Last Update Date : 02/23/2026

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Directions to “LILY SHROYER LCSW LLC ” Practice Location

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