MEDICARE: LILAC COUNSELING

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1568276251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LILAC COUNSELING

Provider Business Mailing Address
First Line	:	73 TURNPIKE ST # 1005
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-5045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	370 SUTTON ST
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-5045
Country	:	US
Telephone Number	:	978-228-5165
Fax Number	:

Authorized Official
Title or Position	:	LICSW
Name	:	SARAH PARKER
Credential	:
Telephone Number	:	978-228-5165

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	02/04/2025

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