Provider Demographics
NPI:1194204867
Name:BABCOCK, LILLIAN (MA, EDS)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:MA, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 BLAIRSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BLAIRSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07825-3536
Mailing Address - Country:US
Mailing Address - Phone:908-674-4432
Mailing Address - Fax:
Practice Address - Street 1:269 STATE ROUTE 31 S STE 5
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-4086
Practice Address - Country:US
Practice Address - Phone:908-652-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health