Provider Demographics
NPI:1770111437
Name:LILLI, CASSANDRA (DO)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:LILLI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 FAIRGROVE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-9617
Mailing Address - Country:US
Mailing Address - Phone:828-326-3000
Mailing Address - Fax:
Practice Address - Street 1:1120 FAIRGROVE CHURCH RD STE 12
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-9630
Practice Address - Country:US
Practice Address - Phone:828-326-2828
Practice Address - Fax:828-326-2829
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2024-006092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry