Provider Demographics
NPI:1790350841
Name:RIOS, JILL (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 SW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-2217
Mailing Address - Country:US
Mailing Address - Phone:806-290-8048
Mailing Address - Fax:866-611-5625
Practice Address - Street 1:521 SW 8TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79101-2217
Practice Address - Country:US
Practice Address - Phone:806-290-8048
Practice Address - Fax:866-611-5625
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX78761OtherLICENSED PROFESSIONAL COUNSELOR