Provider Demographics
NPI:1366612111
Name:KILLIAN, DON RANDALL JR (MS, LPCA)
Entity type:Individual
Prefix:MR
First Name:DON
Middle Name:RANDALL
Last Name:KILLIAN
Suffix:JR
Gender:M
Credentials:MS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CONTINENTAL DR
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28731-9778
Mailing Address - Country:US
Mailing Address - Phone:828-595-3006
Mailing Address - Fax:
Practice Address - Street 1:115 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:NC
Practice Address - Zip Code:28731-9778
Practice Address - Country:US
Practice Address - Phone:828-595-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8028101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health