Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124390786 Individual Practitioner Male Practitioner

Jerry Duane Lilly , EDS

Counselor - Professional • Eagle, ID

Professional Overview & Biography Verified Profile Summary

Jerry Lilly, EDS is a registered healthcare professional specializing in Counselor - Professional in Eagle, ID. Practice services are available at 172 S ACADEMY AVE STE 160 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

172 S Academy Ave Ste 160

Eagle, ID 836166564

Telephone 2083154855
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Eagle, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 42.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
23 Specialists

Practicing in Eagle, ID (1223 Statewide)

Telehealth Adoption Rate
4.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-07-04
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License ID LCPC-6990

Definition to come...

Secondary Practice Locations

12073 N Humphreys Way

Boise, ID 837149343

Phone: 2083154855

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Frances Zucco , LMHC, LPCC, NCC

Counselor - Mental Health

NPI 1588845622

Licensed Mental Health Counselor, Licensed Professional Clinical Counselor, National Certified Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location December 06, 2023

Registered at 172 S ACADEMY AVE STE 160, EAGLE, ID 836166564 (Tel: 2083154855)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 10, 2022

Counselor (License #LCPC-6990 in ID)

NPI Profile Active January 29, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location January 29, 2012

Registered at 12073 N HUMPHREYS WAY, BOISE, ID 837149343 (Tel: 2083154855)

📍
Updated Business Mailing Address January 29, 2012

Registered at 12073 N HUMPHREYS WAY, BOISE, ID 837149343 (Tel: 2083154855)

👤
Provider Name / Credentials Updated January 29, 2012

Recorded as JERRY LILLY, ED.S

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 29, 2012

Counselor (License #LPC-802 in ID)

🟢
Initial NPI Registration & Enumeration January 29, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124390786
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 29, 2012
Last Update: September 11, 2025
Sole Proprietor: Yes

Mailing Address

12073 N Humphreys Way

Boise, ID 837149343

Phone: 2083154855

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.