Lillian Hurley-Hines
Individual provider Active NPI Mental Health Counselor · Mead, CO
NPI 1124523162 · NPPES record last updated Dec 9, 2022
Key facts
- NPI
- 1124523162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 39004069A (IN)
- Practice address
- 14813 Lineback Dr
Mead, CO 80542-4050 - Phone
- (618) 719-7708
- NPI assigned
- Mar 29, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 26, 2024 through Jul 26, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39004069A | IN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resilient Roots Psychotherapy, PLLC | Mental Health | Current |
Accepting new patients |
Locations
210 Ken Pratt Blvd
Ste 140
Longmont, CO 80501
Phone (305) 209-4581
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39004069A | IN | Yes |
Addresses
Primary practice location
14813 Lineback Dr
Mead, CO 80542-4050
Mailing address
#1030 210 Ken Pratt Blvd
Ste 140
Longmont, CO 80501-0193
Phone (812) 906-5929
Other practice location 1
806 N Samuel Moore Pkwy
Mooresville, IN 46158-1467
Phone (317) 584-3178
Other providers in Mead, CO
- Dinomite Smiles Pediatric Dentistry
- Diane Eberle
- Michelle Ferraioli
- Kristyn Granahan
- Elizabeth Har-Noy
- Kingfisher Foundation, Inc.
- Jamie L Kocol
- Debbie Kunkel
- Rachael Karen Lane-Sugg
- Meriah Dawn Leigh
All providers in Mead, CO · Mental Health Counselor in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.