Provider Demographics
NPI:1598499238
Name:A LILLY COUNSELING & CONSULTING LLC
Entity Type:Organization
Organization Name:A LILLY COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LILLY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-395-3391
Mailing Address - Street 1:5534 SAINT JOE RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46835-3328
Mailing Address - Country:US
Mailing Address - Phone:317-395-3391
Mailing Address - Fax:
Practice Address - Street 1:333 N ALABAMA ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2034
Practice Address - Country:US
Practice Address - Phone:317-395-3391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-10
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health