Provider Demographics
NPI:1154654747
Name:PASSAUER, LILLIAN ADELLE (LCSW)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:ADELLE
Last Name:PASSAUER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:ADELLE
Other - Last Name:LIPPINCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6717 HUNTERS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-5403
Mailing Address - Country:US
Mailing Address - Phone:918-764-5203
Mailing Address - Fax:
Practice Address - Street 1:4350 SIGMA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4421
Practice Address - Country:US
Practice Address - Phone:918-764-5203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX546621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical