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Individual
TRISTAN WAYNE KILLIAN
Active
Individual
TRISTAN WAYNE KILLIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LCAS, CCS
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C015255
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-25220
NC
101YP2500X
Professional Counselor
C015255
NC
1041C0700X
Clinical Social Worker
Primary
C015255
NC
171M00000X
Case Manager/Care Coordinator
C015255
NC
Other
Enumeration date
08/02/2019
Last updated
06/21/2023
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