Provider Demographics
NPI:1043498157
Name:BOUNDS, JILL ERIN (MA, LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ERIN
Last Name:BOUNDS
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ANGLER DR
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-6401
Mailing Address - Country:US
Mailing Address - Phone:432-563-4144
Mailing Address - Fax:817-255-2657
Practice Address - Street 1:3131 SANGUINET ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-5336
Practice Address - Country:US
Practice Address - Phone:817-255-2652
Practice Address - Fax:817-255-2657
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190965704Medicaid