Provider Demographics
NPI:1871235135
Name:JILL COUNSELING
Entity Type:Organization
Organization Name:JILL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:I
Authorized Official - Last Name:LUISZER LEMIEUX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-692-5009
Mailing Address - Street 1:9046 W SEAPINKS LN
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-5306
Mailing Address - Country:US
Mailing Address - Phone:757-692-5009
Mailing Address - Fax:
Practice Address - Street 1:7647 W GULF TO LAKE HIGHWAY SUITE 3
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429
Practice Address - Country:US
Practice Address - Phone:757-692-5009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty