Provider Demographics
NPI:1013106475
Name:LILLEY, ERIN L
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:L
Last Name:LILLEY
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 1:241 BOSTON ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1616
Mailing Address - Country:US
Mailing Address - Phone:857-334-4172
Mailing Address - Fax:617-427-9214
Practice Address - Street 1:241 BOSTON ST
Practice Address - Street 2:UNIT 2
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-1616
Practice Address - Country:US
Practice Address - Phone:857-334-4172
Practice Address - Fax:617-427-9214
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1150111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical