Provider Demographics
NPI:1982694949
Name:KROW-JONES, LILLIAN M (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:M
Last Name:KROW-JONES
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 CASTOR DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-1924
Mailing Address - Country:US
Mailing Address - Phone:719-406-3477
Mailing Address - Fax:855-775-0361
Practice Address - Street 1:720 N MAIN ST STE 240
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3046
Practice Address - Country:US
Practice Address - Phone:719-406-3477
Practice Address - Fax:855-775-0361
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9892771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07588007Medicaid
CO45975OtherCIGNA
68566Medicare UPIN
CO07588007Medicaid