Walden Lilly LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

WALDEN LILLY LLC

Doing business as

Stability & Wellness

Practice address

1702 Conservation TRL Unit 104
Fort Walton Beach, FL 32547-5087

Phone

(304) 731-5195

NPI assigned

Jan 29, 2024

Last updated

Jan 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Stephanie Diane Lilly, APRN, PMHNPBC, FNPBCNPI 1194200147

Title

Owner

Phone

(304) 731-5195

Specialties & licenses 1

Addresses

Other names 1

• Stability & Wellness Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Diane Lilly, PMHNP-BC, FNP-BC

  • Family Nurse Practitioner
  • Fort Walton Beach, FL
  • NPI 1194200147
  NPD Authorized official

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1790547313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 CONSERVATION TRL UNIT 104",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325475087",
            "telephone_number": "304-731-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 CONSERVATION TRL UNIT 104",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325475087",
            "telephone_number": "304-731-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDEN LILLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "LILLY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-731-5195",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN, PMHNPBC, FNPBC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stability & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paula S Wadbrook, MD
• Sylvia Wages, APRN
• Logan Wais, LMT
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0919)
• Wal-Mart Stores East, LP (Vision Center 30-0919)
• Walgreen Co (Walgreens #04848)
• Walgreen Co (Walgreens #05582)
• Cecelia Walker
• Christy Lynn Walker
• Marilyn C Walker, RBT

• Psychiatric/Mental Health Nurse Practitioner in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.