Provider Demographics
NPI:1760614408
Name:CORRELL, LILLI RUTH (LPC)
Entity Type:Individual
Prefix:
First Name:LILLI
Middle Name:RUTH
Last Name:CORRELL
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 1:6104 OLD FREDERICKSBURG RD # 92372
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1216
Mailing Address - Country:US
Mailing Address - Phone:512-517-5863
Mailing Address - Fax:
Practice Address - Street 1:6104 OLD FREDERICKSBURG RD # 92732
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1216
Practice Address - Country:US
Practice Address - Phone:512-345-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional