Provider Demographics
NPI:1376249540
Name:WESOLOWSKI, LILY ROZE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LILY
Middle Name:ROZE
Last Name:WESOLOWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12354 BACK RD
Mailing Address - Street 2:
Mailing Address - City:TOMS BROOK
Mailing Address - State:VA
Mailing Address - Zip Code:22660-2412
Mailing Address - Country:US
Mailing Address - Phone:410-206-9363
Mailing Address - Fax:
Practice Address - Street 1:12354 BACK RD
Practice Address - Street 2:
Practice Address - City:TOMS BROOK
Practice Address - State:VA
Practice Address - Zip Code:22660-2412
Practice Address - Country:US
Practice Address - Phone:410-206-9363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040183301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical