Provider Demographics
NPI:1528173721
Name:LILLARD, JILL M (MA LPC)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:M
Last Name:LILLARD
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 BRIAR VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-9000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211A OSCAR DRIVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101
Practice Address - Country:US
Practice Address - Phone:572-635-8299
Practice Address - Fax:573-635-4629
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000170906101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor