Healthcare Provider Details

I. General information

NPI: 1356882922
Provider Name (Legal Business Name): KAREN LILL LPC, ATR, ACS, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 CHAMBLEE DUNWOODY RD STE D2
CHAMBLEE GA
30341-2064
US

IV. Provider business mailing address

3720 CHAMBLEE DUNWOODY RD STE D2
CHAMBLEE GA
30341-2064
US

V. Phone/Fax

Practice location:
  • Phone: 678-744-6750
  • Fax:
Mailing address:
  • Phone: 678-744-6750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC011953
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number18-041
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: