Provider Demographics
NPI:1043101926
Name:ROKUSKIE, JILLIAN ELIZABETH
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:ELIZABETH
Last Name:ROKUSKIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 ARBOR FOREST DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7533
Mailing Address - Country:US
Mailing Address - Phone:919-616-8829
Mailing Address - Fax:
Practice Address - Street 1:9003 WESTON PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2201
Practice Address - Country:US
Practice Address - Phone:919-677-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health