| Lily Carr, LCSW | |
|
106 Marian Way, Pismo Beach, CA 93449-3225 | |
| (805) 858-8576 | |
| Not Available |
| Full Name | Lily Carr |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 106 Marian Way, Pismo Beach, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194367144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 75910 (California) | Primary |
| Entity Name | Wilshire Connected Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104392885 PECOS PAC ID: 5890038558 Enrollment ID: O20190521000171 |
| Mailing Address | Practice Location Address |
|---|---|
| Lily Carr, LCSW Po Box 681, Pismo Beach, CA 93448-0681 Ph: (805) 858-8576 | Lily Carr, LCSW 106 Marian Way, Pismo Beach, CA 93449-3225 Ph: (805) 858-8576 |
Larisa Traga, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 330 James Way Ste 110, Pismo Beach, CA 93449 Phone: 805-266-3231 Fax: 805-262-6275 | |
Bianca Katalina Crystal Taylor, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 310 James Way Ste 150, Pismo Beach, CA 93449 Phone: 805-206-3354 | |
Joann Marie Berge, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 831 Stratford St, Pismo Beach, CA 93449 Phone: 805-773-2724 |