Provider Demographics
NPI:1083465470
Name:JAGMIN, JILLIAN (LPC)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:JAGMIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 E HIGHWAY 290 STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1157
Mailing Address - Country:US
Mailing Address - Phone:281-793-8588
Mailing Address - Fax:
Practice Address - Street 1:6633 E HIGHWAY 290 STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1157
Practice Address - Country:US
Practice Address - Phone:281-793-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86738101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health