Provider Demographics
NPI:1184371809
Name:PEACE LILY THERAPY, PLLC
Entity type:Organization
Organization Name:PEACE LILY THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEIFER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-337-3223
Mailing Address - Street 1:3144 N RIDGEWAY AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6616
Mailing Address - Country:US
Mailing Address - Phone:828-337-3223
Mailing Address - Fax:
Practice Address - Street 1:3144 N RIDGEWAY AVE APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6616
Practice Address - Country:US
Practice Address - Phone:828-337-3223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty