Provider Demographics
NPI:1659420016
Name:SILLAMAN, LOIS JEAN (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:JEAN
Last Name:SILLAMAN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-9142
Mailing Address - Country:US
Mailing Address - Phone:719-275-4409
Mailing Address - Fax:719-275-4409
Practice Address - Street 1:3130 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-9142
Practice Address - Country:US
Practice Address - Phone:719-275-4409
Practice Address - Fax:719-275-4409
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2610101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health