Provider Demographics
NPI:1679250716
Name:WELCH, LILYA RAYNE (CSW)
Entity type:Individual
Prefix:
First Name:LILYA
Middle Name:RAYNE
Last Name:WELCH
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 LYNN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3611
Mailing Address - Country:US
Mailing Address - Phone:859-788-8326
Mailing Address - Fax:
Practice Address - Street 1:1056 WELLINGTON WAY STE 160
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-2002
Practice Address - Country:US
Practice Address - Phone:859-201-1705
Practice Address - Fax:859-207-5481
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2580061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical