Provider Demographics
NPI:1972711232
Name:SCHILLER, JENNIFER A (LMFT, JD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:LMFT, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 BRECKENRIDGE LN STE 208
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3870
Mailing Address - Country:US
Mailing Address - Phone:502-721-0321
Mailing Address - Fax:
Practice Address - Street 1:215 BRECKENRIDGE LN STE 208
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3870
Practice Address - Country:US
Practice Address - Phone:502-721-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0671106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist