Provider Demographics
NPI:1356882922
Name:LILL, KAREN (LPC, ATR, ACS, NCC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LILL
Suffix:
Gender:F
Credentials:LPC, ATR, ACS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 CHAMBLEE DUNWOODY RD STE D2
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-2064
Mailing Address - Country:US
Mailing Address - Phone:678-744-6750
Mailing Address - Fax:
Practice Address - Street 1:3720 CHAMBLEE DUNWOODY RD STE D2
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-2064
Practice Address - Country:US
Practice Address - Phone:678-744-6750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
18-041221700000X
GALPC011953101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist