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NPI Code Detail

MEDICARE: BETH LILJESTRAND

MEDICARE: BETH LILJESTRAND
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 CounselorMH7203FL

General Provider Information

NPI Number : 1447695788
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETH LILJESTRAND
Provider Business Mailing Address
First Line : 3201 SHAMROCK ST S STE 103
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-3349
Country : US
Telephone Number : 850-661-5466
Fax Number : 850-894-0062
Provider Business Practice Location Address
First Line : 3201 SHAMROCK ST S STE 103
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-3349
Country : US
Telephone Number : 850-661-5466
Fax Number : 850-894-0062
Authorized Official
Title or Position : LMHC
Name : MRS. BETH ANN LILJESTRAND
Credential : MS EDS
Telephone Number : 850-661-5466
Provider Enumeration Date : 04/30/2013
Last Update Date : 04/30/2013

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