Provider Demographics
NPI:1356562524
Name:LILLY, RICK ANTHONY (LPC)
Entity type:Individual
Prefix:MR
First Name:RICK
Middle Name:ANTHONY
Last Name:LILLY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 HOPI TRL
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-4933
Mailing Address - Country:US
Mailing Address - Phone:254-624-7215
Mailing Address - Fax:254-778-7745
Practice Address - Street 1:616 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76501-3249
Practice Address - Country:US
Practice Address - Phone:254-624-7215
Practice Address - Fax:254-778-7745
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19287101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor