Provider Demographics
NPI:1689324089
Name:ABERNATHY, JILL N (LPC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:N
Last Name:ABERNATHY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:KS
Mailing Address - Zip Code:67492-0147
Mailing Address - Country:US
Mailing Address - Phone:785-571-7439
Mailing Address - Fax:
Practice Address - Street 1:200 SOUTHWIND PL STE 203
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-3186
Practice Address - Country:US
Practice Address - Phone:785-571-7439
Practice Address - Fax:785-301-8564
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03967101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional