Organization
LILYCO SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDO OXENDINE (CHIEF EXECUTIVE OFFICER)
(919) 395-8032
Entity
Organization
Contact information
Practice address
112 W WINDER ST, HENDERSON, NC 27536-4239
(919) 395-8032
(919) 395-8032
Mailing address
7004 SPANGLERS SPRING WAY, RALEIGH, NC 27610-5271
(919) 395-8032
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588641880
—
NC
05
—
1861730095
—
NC
Enumeration date
07/14/2017
Last updated
08/21/2025
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