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NPI Code Detail

MEDICARE: JILLYAN COLLICA LPCC

MEDICARE: JILLYAN COLLICA LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE.2606021OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073015558
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLYAN COLLICA LPCC
Provider Business Mailing Address
First Line : 1000 S CLEVELAND MASSILLON RD STE 1
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-9204
Country : US
Telephone Number : 330-754-4844
Fax Number : 833-974-2062
Provider Business Practice Location Address
First Line : 1000 S CLEVELAND MASSILLON RD STE 1
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-9204
Country : US
Telephone Number : 330-754-4844
Fax Number : 833-974-2062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2018
Last Update Date : 04/13/2026

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Directions to “ JILLYAN COLLICA LPCC” Practice Location

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