Provider Demographics
NPI:1942398243
Name:CARROLL, JILLIAN LOUSIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:LOUSIE
Last Name:CARROLL
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 1:4041 S CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-4611
Mailing Address - Country:US
Mailing Address - Phone:617-510-1056
Mailing Address - Fax:860-540-0041
Practice Address - Street 1:4041 S CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-4611
Practice Address - Country:US
Practice Address - Phone:617-510-1056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006369101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health