Lillian De Petrillo, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY1000892 Issued in DC

Practice address

1729 21St St NW
Washington, DC 20009-1101

Phone

(202) 234-0903

NPI assigned

Oct 25, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2014 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1962755157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 21ST ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200091101",
            "telephone_number": "202-234-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 21ST ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200091101",
            "telephone_number": "202-234-0903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4719 Hampden Ln",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208143074",
            "country_code": "US",
            "telephone_number": "301-656-4600 x5837",
            "fax_number": "301-656-4601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE PETRILLO",
        "first_name": "LILLIAN",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivette De Leon
• Anny Elizabeth De Los Santos
• Deogracias Villa De Luna
• Lorenzo De Marchi, MD
• Karine De Oliveira Dias, MD
• Margaret De Pont
• Olivier Jean De Raet, M.D., MBA
• Olivier De Senarclens
• Brittany De Silva
• Alexis W De'Sert, LPC

• Clinical Psychologist in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Psychologist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.