Provider Demographics
NPI:1477854610
Name:SYLVESTER, LILLIAN M (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:M
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:L
Other - Middle Name:M
Other - Last Name:SYLVESTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:PO BOX 1381
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20768-1381
Mailing Address - Country:US
Mailing Address - Phone:301-313-0159
Mailing Address - Fax:301-313-0159
Practice Address - Street 1:7935 BELLE POINT DR
Practice Address - Street 2:MOSAIC EXPRESSIVE ARTS THERAPIES
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3329
Practice Address - Country:US
Practice Address - Phone:301-313-0159
Practice Address - Fax:301-313-0159
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2011-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3728101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD038381300Medicaid