Individual provider · Type 1 NPI

Jerry Duane Lilly, ED.S

Professional Counselor · Eagle, ID

NPI number 1124390786 Active

Practice location

172 S Academy Ave Ste 160
Eagle, ID 83616-6564

Call (208) 315-4855 Map

Mailing address

12073 N Humphreys Way
Boise, ID 83714-9343

Other practice locations

  • 12073 N Humphreys Way, Boise, ID 83714-9343 · (208) 315-4855

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XLCPC-6990 (ID)

Professional Counselor: Definition to come...

2 other providers at this address

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About NPI 1124390786

Jerry Duane Lilly, ED.S's National Provider Identifier is 1124390786, issued on Jan 29, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Eagle, ID. The record was last updated on Sep 11, 2025.