Provider Demographics
NPI:1497516611
Name:HOLCOMB, LILY (LMFTA)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:LILY
Other - Middle Name:
Other - Last Name:SKLENAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:118 FIELDSTONE LN
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:CT
Mailing Address - Zip Code:06238-1409
Mailing Address - Country:US
Mailing Address - Phone:860-756-6391
Mailing Address - Fax:
Practice Address - Street 1:25 ELM ST
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2305
Practice Address - Country:US
Practice Address - Phone:860-563-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3130106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist