Individual provider Active NPI

Justin Lillis, APC

  • Counselor
  • Atlanta, GA
National Provider Identifier
1073420634
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
APC010916 Issued in GA
Practice address
690 Courtenay Dr NE
Atlanta, GA 30306-3421
Phone
(404) 875-4551
Fax
(404) 892-1770
NPI assigned
Aug 27, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X APC010916 GA Primary

Addresses

Primary practice location

690 Courtenay Dr NE
Atlanta, GA 30306-3421

Mailing address

690 Courtenay Dr NE
Atlanta, GA 30306-3421
Phone (404) 875-4551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1073420634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 COURTENAY DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303063421",
            "telephone_number": "404-875-4551",
            "fax_number": "404-892-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 COURTENAY DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303063421",
            "telephone_number": "404-875-4551",
            "fax_number": "404-892-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLIS",
        "first_name": "JUSTIN",
        "credential": "APC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "APC010916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.