Provider Demographics
NPI:1114905627
Name:YAPPLE, JILL FERRELL (LPA, HSP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:FERRELL
Last Name:YAPPLE
Suffix:
Gender:F
Credentials:LPA, HSP
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:ELIZABETH
Other - Last Name:FERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPA, HSP
Mailing Address - Street 1:2002 EASTWOOD RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-7218
Mailing Address - Country:US
Mailing Address - Phone:910-509-0588
Mailing Address - Fax:910-509-0586
Practice Address - Street 1:2002 EASTWOOD RD
Practice Address - Street 2:SUITE 305
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7218
Practice Address - Country:US
Practice Address - Phone:910-509-0588
Practice Address - Fax:910-509-0586
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2430103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC046UTOtherBC/BS
NC6107048Medicaid