Provider Demographics
NPI:1083774905
Name:LILLIE, BILLIE K SR (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:K
Last Name:LILLIE
Suffix:SR
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 LEE ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1428
Mailing Address - Country:US
Mailing Address - Phone:303-239-8940
Mailing Address - Fax:303-239-0323
Practice Address - Street 1:2470 LEE ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1428
Practice Address - Country:US
Practice Address - Phone:303-239-8940
Practice Address - Fax:303-239-0323
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO984015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC457638Medicare PIN