Provider Demographics
NPI:1326028101
Name:LILLARD, DORIS V (LPC)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:V
Last Name:LILLARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 WHITE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:AR
Mailing Address - Zip Code:72522-9722
Mailing Address - Country:US
Mailing Address - Phone:870-799-8118
Mailing Address - Fax:
Practice Address - Street 1:1507 N PECAN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-2867
Practice Address - Country:US
Practice Address - Phone:870-523-3643
Practice Address - Fax:870-523-8224
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9808021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health