Provider Demographics
NPI:1235454869
Name:HOOD, LILLIAN CARMEN (LPA, LCAS)
Entity Type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:CARMEN
Last Name:HOOD
Suffix:
Gender:F
Credentials:LPA, LCAS
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:CARMEN
Other - Last Name:GUTHRIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1112 HARBOUR DR APT 203
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7753
Mailing Address - Country:US
Mailing Address - Phone:910-520-0028
Mailing Address - Fax:
Practice Address - Street 1:615 SHIPYARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6431
Practice Address - Country:US
Practice Address - Phone:910-343-0145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3931103T00000X
NCLCAS 2354101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)