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NPI Code Detail

MEDICARE: LILLIE FLOWERS LGSW

MEDICARE: LILLIE FLOWERS LGSW
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 Worker6366CAL

General Provider Information

NPI Number : 1851834519
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILLIE FLOWERS LGSW
Provider Business Mailing Address
First Line : PO BOX 8459
Second Line :
City : PORTLAND
State : OR
Zip : 97207-8459
Country : US
Telephone Number : 503-238-0769
Fax Number :
Provider Business Practice Location Address
First Line : 212 W TROY ST STE B
Second Line :
City : DOTHAN
State : AL
Zip : 36303-4455
Country : US
Telephone Number : 205-421-8064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2016
Last Update Date : 10/08/2025

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