Mr Tage Alan Lilja, MSW, LICSW | |
125 Saint Paul St Ste 107, Burlington, VT 05401-8462 | |
(802) 391-9865 | |
Not Available |
Full Name | Mr Tage Alan Lilja |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 125 Saint Paul St Ste 107, Burlington, Vermont |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780827147 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 089.0106322 (Vermont) | Primary |
Entity Name | Tage Lilja Licsw Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205500329 PECOS PAC ID: 9032515499 Enrollment ID: O20210909002960 |
Mailing Address | Practice Location Address |
---|---|
Mr Tage Alan Lilja, MSW, LICSW 391 Southwind Rd, Hinesburg, VT 05461-4448 Ph: (802) 391-9865 | Mr Tage Alan Lilja, MSW, LICSW 125 Saint Paul St Ste 107, Burlington, VT 05401-8462 Ph: (802) 391-9865 |
Shannon Kadish, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-488-6600 | |
Elyza Moore, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-488-6000 Fax: 802-488-6919 | |
Ellyn Leamon, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-863-1326 | |
Lauren Carpenter, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 617 Riverside Ave, Burlington, VT 05401 Phone: 802-864-6309 | |
Elaine Soto, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 300 Flynn Ave, Burlington, VT 05401 Phone: 802-488-6300 | |
Jenifer D'aiello, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1 S Prospect St, Burlington, VT 05401 Phone: 802-847-5331 Fax: 802-847-7765 | |
Kathleen Browne, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 617 Riverside Ave, Burlington, VT 05401 Phone: 802-864-6309 Fax: 802-860-4324 |