Provider Demographics
NPI:1346436466
Name:HEWITT, JILL ELIZABETH (MS, LMFT)
Entity Type:Individual
Prefix:MISS
First Name:JILL
Middle Name:ELIZABETH
Last Name:HEWITT
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MRS
Other - First Name:JILL
Other - Middle Name:ELIZABETH
Other - Last Name:STOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:716 SIBLEY AVE
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MN
Mailing Address - Zip Code:55334-2386
Mailing Address - Country:US
Mailing Address - Phone:507-237-9987
Mailing Address - Fax:507-237-2027
Practice Address - Street 1:716 SIBLEY AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MN
Practice Address - Zip Code:55334-2386
Practice Address - Country:US
Practice Address - Phone:507-237-9987
Practice Address - Fax:507-237-2027
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1102106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist