Provider Demographics
NPI:1770473191
Name:DICKINSON, LILY MAE (MSW)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:MAE
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:BILLY
Other - Middle Name:MAE
Other - Last Name:DICKINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:123 W MAIN ST STE 310
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3654
Mailing Address - Country:US
Mailing Address - Phone:919-371-6928
Mailing Address - Fax:984-220-9387
Practice Address - Street 1:123 W MAIN ST STE 310
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3654
Practice Address - Country:US
Practice Address - Phone:919-371-6928
Practice Address - Fax:984-220-9387
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0223701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical