Provider Demographics
NPI:1225045065
Name:LILLER, HAROLD JOSEPH SR (LPCC-SUP)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:JOSEPH
Last Name:LILLER
Suffix:SR
Gender:M
Credentials:LPCC-SUP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 BOARDMAN CANFIELD RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4236
Mailing Address - Country:US
Mailing Address - Phone:330-953-1964
Mailing Address - Fax:877-253-7181
Practice Address - Street 1:833 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4236
Practice Address - Country:US
Practice Address - Phone:330-953-1964
Practice Address - Fax:877-253-7181
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001991101Y00000X
OHE0002651101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH068691Medicare PIN