Provider Demographics
NPI:1407623168
Name:PRADO, LILLIAN STEPHANIE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:STEPHANIE
Last Name:PRADO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:LILLIAN
Other - Middle Name:S
Other - Last Name:PRADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:242 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-8127
Mailing Address - Country:US
Mailing Address - Phone:929-388-1207
Mailing Address - Fax:
Practice Address - Street 1:242 E 2ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-8127
Practice Address - Country:US
Practice Address - Phone:929-388-1207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115987-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker