Provider Demographics
NPI:1174342711
Name:LILLER-REEDY, LISA NADINE (RESIDENT IN COUNSELI)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:NADINE
Last Name:LILLER-REEDY
Suffix:
Gender:F
Credentials:RESIDENT IN COUNSELI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CHESTER ST
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-3389
Mailing Address - Country:US
Mailing Address - Phone:540-612-2042
Mailing Address - Fax:
Practice Address - Street 1:115 CHESTER ST
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3389
Practice Address - Country:US
Practice Address - Phone:540-612-2042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013957101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional