Provider Demographics
NPI:1306203112
Name:RYON, JILL (LCSW-A)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:RYON
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ALEXANDER CRST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-7756
Mailing Address - Country:US
Mailing Address - Phone:828-458-1342
Mailing Address - Fax:
Practice Address - Street 1:120 S GROVE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-4007
Practice Address - Country:US
Practice Address - Phone:828-697-2660
Practice Address - Fax:828-697-2986
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0102421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical