Lily Bollinger PSYD LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

NJ4003 Issued in NJ

Legal business name

LILY BOLLINGER PSYD LLC

Practice address

1 Eves Dr Ste 146
Marlton, NJ 08053-3125

Phone

(856) 701-6446

Fax

(856) 596-7299

NPI assigned

Aug 2, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Lily Bollinger, PSYDNPI 1649369497

Title

Owner

Phone

(856) 701-6446

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Lily W Bollinger, PSYD

  • Psychologist
  • Haddonfield, NJ
  • NPI 1649369497
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1255855185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EVES DR STE 146",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533125",
            "telephone_number": "856-701-6446",
            "fax_number": "856-596-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EVES DR STE 146",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533125",
            "telephone_number": "856-701-6446",
            "fax_number": "856-596-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILY BOLLINGER PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BOLLINGER",
        "authorized_official_first_name": "LILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-701-6446",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "NJ4003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Marlton, NJ
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• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.