Provider Demographics
NPI:1750550430
Name:NUNEZ, LILLIAN JANE (MA, LPC)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:JANE
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 E CARLETON RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-1619
Mailing Address - Country:US
Mailing Address - Phone:517-403-4229
Mailing Address - Fax:517-437-7101
Practice Address - Street 1:11 E CARLETON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-1619
Practice Address - Country:US
Practice Address - Phone:517-403-4229
Practice Address - Fax:517-437-7101
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional