Individual
JENNIFER N LILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CSAC
Contact information
Practice address
N64W24050 MAIN ST STE 207, SUSSEX, WI 53089-3000
(262) 501-6533
Mailing address
W245N6630 BOWLING GREEN ST, SUSSEX, WI 53089-2638
(262) 501-6533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16400-132
WI
1041C0700X
Clinical Social Worker
Primary
9100-123
WI
Other
Enumeration date
04/03/2017
Last updated
10/05/2023
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