JERRY DUANE LILLY ED.S
NPI 1124390786
Counselor - Professional in Eagle, ID
About Jerry Duane Lilly Ed.s NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JERRY DUANE LILLY ED.S (NPI 1124390786) is an individual professional provider in Eagle, Idaho, licensed in Idaho (LCPC-6990) and active in the NPI registry since January 2012. He has opted out of Medicare through July 31, 2028 and maintains a secondary practice location in Boise.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Jerry Duane Lilly Ed.s has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 31, 2024 through July 31, 2028.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
EAGLE, ID 83616
EAGLE, ID 83616
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jerry Lilly's NPI number?
The NPI number for Jerry Lilly is 1124390786. It was assigned to this individual provider in the NPPES registry on January 29, 2012.
Where is Jerry Lilly located?
Jerry Lilly practices at 172 S Academy Ave Ste 160, Eagle, ID 83616. The listed phone number is (208) 315-4855.
What is Jerry Lilly's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Jerry Lilly enrolled in Medicare?
No. Jerry Lilly has opted out of Medicare through July 31, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
What insurance does Jerry Lilly accept?
Health plans from PacificSource Health Plans and Select Health list Jerry Lilly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jerry Lilly was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jerry Duane Lilly, ED.S · NPI 1124390786
Professional provider in Eagle, Idaho. Individual provider, active in the CMS NPPES registry since January 29, 2012.
## Identity
- **NPI:** 1124390786 (Entity type: Individual)
- **Enumerated:** January 29, 2012
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LCPC-6990 (Idaho)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 172 S ACADEMY AVE STE 160, Eagle, ID 83616-6564
- **Phone:** (208) 315-4855
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through July 31, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** September 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1124390786) · Data from the CMS NPPES public registry.