Provider Demographics
NPI:1619988235
Name:BILIS, GRACIELA LILIANA (LPC, LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:GRACIELA
Middle Name:LILIANA
Last Name:BILIS
Suffix:
Gender:F
Credentials:LPC, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 CAMELBACK DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-8074
Mailing Address - Country:US
Mailing Address - Phone:301-829-8881
Mailing Address - Fax:301-829-0088
Practice Address - Street 1:3661 CAMELBACK DR
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-8074
Practice Address - Country:US
Practice Address - Phone:301-829-8881
Practice Address - Fax:301-829-0088
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004003101YP2500X
MDLC2210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional