Provider Demographics
NPI:1598381253
Name:JILLIAN CARLAN COUNSELING PLLC
Entity Type:Organization
Organization Name:JILLIAN CARLAN COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-590-8663
Mailing Address - Street 1:10515 W MARKHAM ST # 3
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2297
Mailing Address - Country:US
Mailing Address - Phone:501-590-8663
Mailing Address - Fax:
Practice Address - Street 1:10515 W MARKHAM ST # 3
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2297
Practice Address - Country:US
Practice Address - Phone:501-590-8663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty