Provider Demographics
NPI:1154971083
Name:KILLIAN, DANIEL (LPC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:KILLIAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 RIDGEWAY DR STE B1
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3446
Mailing Address - Country:US
Mailing Address - Phone:337-222-9217
Mailing Address - Fax:
Practice Address - Street 1:119 RIDGEWAY DR STE B1
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3446
Practice Address - Country:US
Practice Address - Phone:337-735-7542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA8424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator