Provider Demographics
NPI:1295524585
Name:ELLEN LILLA COUNSELING LLC
Entity type:Organization
Organization Name:ELLEN LILLA COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-261-7189
Mailing Address - Street 1:48363 180TH AVE
Mailing Address - Street 2:
Mailing Address - City:ZUMBROTA
Mailing Address - State:MN
Mailing Address - Zip Code:55992-5170
Mailing Address - Country:US
Mailing Address - Phone:507-261-7189
Mailing Address - Fax:
Practice Address - Street 1:231 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PINE ISLAND
Practice Address - State:MN
Practice Address - Zip Code:55963-7659
Practice Address - Country:US
Practice Address - Phone:507-722-2303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-02
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)