Provider Demographics
NPI:1518000751
Name:MCBETH, LILLIANNE VIRGINIA (MSW, LCSW, LISW-CP)
Entity Type:Individual
Prefix:MS
First Name:LILLIANNE
Middle Name:VIRGINIA
Last Name:MCBETH
Suffix:
Gender:F
Credentials:MSW, LCSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 KILBURN LN
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-0016
Mailing Address - Country:US
Mailing Address - Phone:617-817-4868
Mailing Address - Fax:
Practice Address - Street 1:1435 KILBURN LN
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-0016
Practice Address - Country:US
Practice Address - Phone:617-817-4868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10619-CP101YM0800X
NCC008704101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health