Provider Demographics
NPI:1912304080
Name:DILOLLO, ANNALICIA (MS, LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:ANNALICIA
Middle Name:
Last Name:DILOLLO
Suffix:
Gender:F
Credentials:MS, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 S 4TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2001
Mailing Address - Country:US
Mailing Address - Phone:833-472-4267
Mailing Address - Fax:
Practice Address - Street 1:16 S 4TH ST APT A
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2001
Practice Address - Country:US
Practice Address - Phone:833-472-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9681101YM0800X
VA0701011024101YP2500X
PAPC014022101YP2500X
CO0014404101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health