Provider Demographics
NPI:1851933824
Name:MCWILLIAM, LILY
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:MCWILLIAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 2ND AVENUE
Mailing Address - Street 2:CENTER FOR COMPREHENSIVE HEALTH PRACTICE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-360-7828
Mailing Address - Fax:
Practice Address - Street 1:1901 2ND AVENUE
Practice Address - Street 2:CENTER FOR COMPREHENSIVE HEALTH PRACTICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-360-7828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-11
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1048721041C0700X
MALICSW1263201041C0700X
CT125241041C0700X
NY0923301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical