Provider Demographics
NPI:1619785342
Name:EYRE, LILLIAN (LPC, PHD, MT-BC)
Entity type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:
Last Name:EYRE
Suffix:
Gender:F
Credentials:LPC, PHD, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5446 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3408
Mailing Address - Country:US
Mailing Address - Phone:267-574-4567
Mailing Address - Fax:
Practice Address - Street 1:5446 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3408
Practice Address - Country:US
Practice Address - Phone:267-574-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005137101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health