Lily Bay LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

PC004551 Issued in PA

Legal business name

LILY BAY LLC

Practice address

15 Weiss Ave
Easton, PA 18042

Phone

(610) 250-7595

Fax

(610) 250-7595

NPI assigned

Jan 3, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Warren Austin

Title

Ceo

Phone

(610) 250-7595

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1730459124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WEISS AVE",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "18042",
            "telephone_number": "610-250-7595",
            "fax_number": "610-250-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WEISS AVE",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "18042",
            "telephone_number": "610-250-7595",
            "fax_number": "610-250-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILY BAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "610-250-7595",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "PA",
            "license": "PC004551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Easton, PA
• Providers in Easton, PA by specialty
• Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.