Provider Demographics
NPI:1710310222
Name:CRESWELL, JILLIAN S (LPC)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:S
Last Name:CRESWELL
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 1:1706 VADA CIR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-5869
Mailing Address - Country:US
Mailing Address - Phone:865-363-9986
Mailing Address - Fax:
Practice Address - Street 1:1706 VADA CIR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-5869
Practice Address - Country:US
Practice Address - Phone:865-363-9986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health