Provider Demographics
NPI:1093817553
Name:LILLARD, NANCY ERMA (MA, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ERMA
Last Name:LILLARD
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 COLLEGE ST
Mailing Address - Street 2:P.O. BOX 5
Mailing Address - City:CANTON
Mailing Address - State:MO
Mailing Address - Zip Code:63435-1342
Mailing Address - Country:US
Mailing Address - Phone:573-288-3048
Mailing Address - Fax:
Practice Address - Street 1:8965 HIGHWAY 36
Practice Address - Street 2:SUITE 5A, BOX 10
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6739
Practice Address - Country:US
Practice Address - Phone:573-406-0818
Practice Address - Fax:573-406-0812
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002110101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional