NPIMap

Organization Active NPI

Lilys Place Family Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Huntington, WV
National Provider Identifier
1689288813
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LILYS PLACE FAMILY CENTER
Practice address
1235 6TH Ave
Huntington, WV 25701-2904
Phone
(304) 523-5459
Fax
(304) 523-8341
NPI assigned
Sep 4, 2020
Organization subpart
Yes
Parent organization
LILY'S PLACE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Authorized official

Name
Mrs. Rebecca Dawn Crowder, MASTER OF ED
Title
Executive Director
Phone
(304) 523-5459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1235 6TH Ave
Huntington, WV 25701-2904

Mailing address

PO Box 2
Huntington, WV 25706
Phone (304) 523-5459

Other identifiers 1

IdentifierTypeStateIssuer
3910005949MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211109002491 WV Part B Supplier - Clinic/Group Practice 6709275902 Receives reassigned benefits from 3 practitioners
Practice locations: Huntington, WV

National Provider Directory

National Provider Directory
Tax ID family
Lily's Place Family Center2 organizations share this tax ID, including this one
Part of
Lily's Place Family Center

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1235 6th Ave
Huntington, WV 25701
Phone (681) 432-0600

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

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": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1689288813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25706",
            "telephone_number": "304-523-5459",
            "fax_number": "304-523-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 6TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012904",
            "telephone_number": "304-523-5459",
            "fax_number": "304-523-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILYS PLACE FAMILY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LILY'S PLACE INC",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "CROWDER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-523-5459",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MASTER OF ED"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3910005949",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.