Pruitt, Lillian Rae

Pruitt, Lillian Rae is an sole proprietor health care provider with primary practice located at 246 Northland Dr Ste 200A , Medina OH 44256-3440. She recently has 4 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Community Health Worker, Agencies / Case Management, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Pruitt, Lillian Rae can be contacted via phone (330) 725-9195.

Contact Information

Primary practice address
246 Northland Dr Ste 200A Medina OH 44256-3440
Phone: (330) 725-9195
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Community Health Worker 172V00000X Ohio
Agencies / Case Management 251B00000X S.2107032 Ohio
Behavioral Health & Social Service Providers / Social Worker 104100000X S.2107032 Ohio

Profile Details

NPI number 1861006702
LBN Legal business name Pruitt, Lillian Rae
Credentials LSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 8th, 2020
Last updated Mar 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861006702 NPPES
Ohio MEDICAID 0417503

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