Provider Demographics
NPI:1417660085
Name:LILAC RIVER COUNSELING , LLC
Entity Type:Organization
Organization Name:LILAC RIVER COUNSELING , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:717-651-1180
Mailing Address - Street 1:1250 N MOUNTAIN RD STE 307
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1795
Mailing Address - Country:US
Mailing Address - Phone:717-585-0098
Mailing Address - Fax:
Practice Address - Street 1:1250 N MOUNTAIN RD STE 307
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1795
Practice Address - Country:US
Practice Address - Phone:717-585-0098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty