Provider Demographics
NPI:1245069855
Name:HEWITT, LILY (MA, LCMHC)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:HEWITT
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 KINNEY DR APT 9
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05464-6205
Mailing Address - Country:US
Mailing Address - Phone:201-403-4078
Mailing Address - Fax:
Practice Address - Street 1:275 ROUTE 15 W
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:VT
Practice Address - Zip Code:05656-9657
Practice Address - Country:US
Practice Address - Phone:802-635-2805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0136066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health