Provider Demographics
NPI:1326649419
Name:SERRANO, LILLIAN (LCSW, BCBA)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:SERRANO
Suffix:
Gender:F
Credentials:LCSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 S DELSEA DR STE 7
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-6398
Mailing Address - Country:US
Mailing Address - Phone:856-305-9627
Mailing Address - Fax:609-939-0479
Practice Address - Street 1:1881 S DELSEA DR STE 7
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6398
Practice Address - Country:US
Practice Address - Phone:856-305-9627
Practice Address - Fax:609-939-0479
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical