Provider Demographics
NPI:1457892366
Name:BARNWELL, LILLIAN (LPC, MAC)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:BARNWELL
Suffix:
Gender:F
Credentials:LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ELLA LN
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3851
Mailing Address - Country:US
Mailing Address - Phone:706-264-1920
Mailing Address - Fax:706-243-6392
Practice Address - Street 1:111 ELLA LN
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3851
Practice Address - Country:US
Practice Address - Phone:706-264-1920
Practice Address - Fax:706-243-6392
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0008034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional