Provider Demographics
NPI:1841322021
Name:MAINO, LILY (MS)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:MAINO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8010 S COUNTY ROAD 5 UNIT 201
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80528-9004
Mailing Address - Country:US
Mailing Address - Phone:970-481-9830
Mailing Address - Fax:
Practice Address - Street 1:8010 S COUNTY ROAD 5 UNIT 201
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80528-9004
Practice Address - Country:US
Practice Address - Phone:970-481-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12478OtherLICENSED PROFESSIONAL COUNSELOR