Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jerry Duane Lilly, EDS

Individual provider Professional Counselor · NPI 1124390786

Jerry Duane Lilly, EDS is a Professional Counselor in Eagle, Idaho. Practices as a sole proprietor and works from 2 locations. Licensed in Idaho.

Licensed in
ID
In the registry since
2012

Practice location Address checks out

172 S Academy Ave Ste 160
Eagle, ID 83616-6564
Phone: (208) 315-4855
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LCPC-6990 (ID)

Record details

NPI number1124390786
Entity typeIndividual (Type 1)
GenderMale
Credentials EDS
Sole proprietorYes
NPI enumeratedJanuary 29, 2012
Last updated in NPPESSeptember 11, 2025
Certification dateJuly 4, 2023
Mailing address12073 N Humphreys Way, Boise, ID 83714-9343

Other providers in Eagle