Brandon Lillard, BA
Individual provider Active NPI Case Manager/Care Coordinator · Waterbury, CT
NPI 1962882324 · NPPES record last updated Jun 1, 2015
Key facts
- NPI
- 1962882324
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 402 E Main St
Waterbury, CT 06702-1701 - Phone
- (203) 755-1143
- Fax
- (203) 753-3274
- NPI assigned
- Jun 1, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
402 E Main St
Waterbury, CT 06702-1701
Mailing address
141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000
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- Rebecca Lima
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- Kingson Lin
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All providers in Waterbury, CT · Case Manager/Care Coordinator in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.