Provider Demographics
NPI:1295450112
Name:LILAC COUNSELING SERVICES
Entity type:Organization
Organization Name:LILAC COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JUNA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:KILLION
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:231-402-0297
Mailing Address - Street 1:800 E ELLIS RD # 565
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-5622
Mailing Address - Country:US
Mailing Address - Phone:231-402-0297
Mailing Address - Fax:
Practice Address - Street 1:800 E ELLIS RD # 565
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-5622
Practice Address - Country:US
Practice Address - Phone:231-402-0297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty