NPIMap

Organization Active NPI

Joe Lilly, LLC

Doing business as Lillybrook Counseling Services

  • Clinical Social Worker
  • Troy, MI
National Provider Identifier
1053881177
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JOE LILLY, LLC
Doing business as
Lillybrook Counseling Services
Practice address
667 E Big Beaver Rd Ste 107
Troy, MI 48083-1430
Phone
(248) 250-6620
Fax
(248) 250-6629
NPI assigned
Dec 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Authorized official

Name
Mr. Joseph Lilly, LMSWNPI 1417204439
Title
Owner
Phone
(248) 250-6620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

667 E Big Beaver Rd Ste 107
Troy, MI 48083-1430

Mailing address

667 E Big Beaver Rd Ste 107
Troy, MI 48083-1430
Phone (248) 250-6620

Other identifiers 2

IdentifierTypeStateIssuer
1447582762OtherTYPE 1 NPI
1417204439OtherTYPE I NPI

Other names 1

  • Lillybrook Counseling Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190325000539 MI Part B Supplier - Clinic/Group Practice 2961742259 Receives reassigned benefits from 4 practitioners
Practice locations: Troy, MI

National Provider Directory

National Provider Directory

Locations

667 E Big Beaver Rd
Ste 107
Troy, MI 48083
Phone (248) 238-8031

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1543622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1053881177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 E BIG BEAVER RD STE 107",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831430",
            "telephone_number": "248-250-6620",
            "fax_number": "248-250-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 E BIG BEAVER RD STE 107",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831430",
            "telephone_number": "248-250-6620",
            "fax_number": "248-250-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOE LILLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-01",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "LILLY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-250-6620",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1447582762",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE I NPI",
            "identifier": "1417204439",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lillybrook Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.