Individual provider Active NPI

Jennifer Afton Lilly, MA, LPCA, NCC

  • Mental Health Counselor
  • Durham, NC
National Provider Identifier
1023529195
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A12611 Issued in NC
Practice address
1822 E. Hwy 54
Suite 300
Durham, NC 27713
Phone
(919) 474-6400
NPI assigned
Oct 17, 2017
Last updated
Oct 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A12611 NC Primary

Addresses

Primary practice location

1822 E. Hwy 54
Suite 300
Durham, NC 27713

Mailing address

904 Park Ridge Rd Apt B10
Durham, NC 27713-9238
Phone (478) 550-8695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A12611NCMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1023529195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 PARK RIDGE RD APT B10",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139238",
            "telephone_number": "478-550-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 E. HWY 54",
            "address_2": "SUITE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27713",
            "telephone_number": "919-474-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "JENNIFER",
        "middle_name": "AFTON",
        "credential": "MA, LPCA, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A12611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.