| Joe Lilly, Llc | |
|
667 E Big Beaver Rd Ste 107 Troy MI 48083-1430 | |
| (248) 250-6620 | |
| (248) 250-6629 |
| Full Name | Joe Lilly, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 667 E Big Beaver Rd Ste 107, Troy, Michigan |
| Authorized Official Name and Position | Joseph Lilly (OWNER) |
| Authorized Official Contact | 2482506620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joe Lilly, Llc 667 E Big Beaver Rd Ste 107 Troy MI 48083-1430 Ph: (248) 250-6620 | Joe Lilly, Llc 667 E Big Beaver Rd Ste 107 Troy MI 48083-1430 Ph: (248) 250-6620 |
| NPI Number | 1053881177 |
|---|---|
| Provider Enumeration Date | 12/01/2018 |
| Last Update Date | 03/03/2023 |
| Certification Date | 03/03/2023 |
| Medicare PECOS PAC ID | 2961742259 |
|---|---|
| Medicare Enrollment ID | O20190325000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053881177 | NPI | - | NPPES |
| 1447582762 | Other | TYPE 1 NPI | |
| 1417204439 | Other | TYPE I NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan Hyde Bakker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447582762 PECOS PAC ID: 0840474888 Enrollment ID: I20110415000185 |
| Provider Name | Joseph A Lilly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417204439 PECOS PAC ID: 7719200344 Enrollment ID: I20150106001129 |
| Provider Name | Linnea Katherine Sieh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710318290 PECOS PAC ID: 1456874379 Enrollment ID: I20250401001067 |
| Provider Name | Sherry Ilyse Wexler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104562966 PECOS PAC ID: 9537688924 Enrollment ID: I20250529000981 |
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