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General NPI Number Information
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NPI Number | 1366727646
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Entity Type | Organization
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Legal Business Name | KILLIAN COUNSELING & CONSULTING
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Dates
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Enumeration Date | 10/18/2011
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 2600 FAR HILLS AVE STE 304
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City | DAYTON
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State | OH
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Zip | 45419-1687
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Country | US
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Telephone | 937-361-4457
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 FAR HILLS AVE STE 304
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City | DAYTON
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State | OH
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Zip | 45419-1687
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Country | US
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Telephone | 937-361-4457
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | VICKIE KILLIAN
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Credential | LISW, LICDC
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Telephone | 937-361-4457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 933459
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0007910
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License Number State | OH
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