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NPI Code Detail

MEDICARE: MS. ERIN REBECCA ILLYES LCSW

MEDICARE: MS. ERIN REBECCA ILLYES LCSW
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 WorkerCW18815PA

General Provider Information

NPI Number : 1699230938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERIN REBECCA ILLYES LCSW
Provider Business Mailing Address
First Line : 300 MAPLE ST
Second Line :
City : LEBANON
State : PA
Zip : 17046-2957
Country : US
Telephone Number : 717-926-4532
Fax Number :
Provider Business Practice Location Address
First Line : 1700 S LINCOLN AVE
Second Line :
City : LEBANON
State : PA
Zip : 17042-7529
Country : US
Telephone Number : 717-272-6621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2019
Last Update Date : 03/26/2026

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