MEDICARE: LILLIE S PARKER M.S., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	2202010298	VA

General Provider Information

NPI Number	:	1457956880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILLIE S PARKER M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	671 BELL ST
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23661-1403
Country	:	US
Telephone Number	:	757-727-1071
Fax Number	:

Provider Business Practice Location Address
First Line	:	671 BELL ST
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23661-1403
Country	:	US
Telephone Number	:	757-727-1071
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	06/02/2026

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