Provider Demographics
NPI:1568607844
Name:LEBAR, JILL M (MA, LMHC, CMC)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:M
Last Name:LEBAR
Suffix:
Gender:F
Credentials:MA, LMHC, CMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 N HOLDEN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2553
Mailing Address - Country:US
Mailing Address - Phone:413-663-5026
Mailing Address - Fax:413-663-5098
Practice Address - Street 1:71 N HOLDEN ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2553
Practice Address - Country:US
Practice Address - Phone:413-663-5026
Practice Address - Fax:413-663-5098
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4205101YM0800X
MA1120171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator