Provider Demographics
NPI:1013970177
Name:SIDLINGER, JILL (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JILL
Middle Name:
Last Name:SIDLINGER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 11TH ST NW
Mailing Address - Street 2:STE A
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732
Mailing Address - Country:US
Mailing Address - Phone:563-243-4490
Mailing Address - Fax:563-243-4585
Practice Address - Street 1:1320 11TH ST NW
Practice Address - Street 2:STE A
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732
Practice Address - Country:US
Practice Address - Phone:563-243-4490
Practice Address - Fax:563-243-4585
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00770101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00770OtherSTATE LICENSE LMHC