MEDICARE: KAREN LILL LPC, ATR, ACS, NCC

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
1	221700000X	Art Therapist	18-041
2	101YP2500X	Professional Counselor	LPC011953	GA

General Provider Information

NPI Number	:	1356882922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LILL LPC, ATR, ACS, NCC

Provider Business Mailing Address
First Line	:	3720 CHAMBLEE DUNWOODY RD STE D2
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2064
Country	:	US
Telephone Number	:	678-744-6750
Fax Number	:

Provider Business Practice Location Address
First Line	:	3720 CHAMBLEE DUNWOODY RD STE D2
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2064
Country	:	US
Telephone Number	:	678-744-6750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2017
Last Update Date	:	03/04/2024

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