Provider Demographics
NPI:1205950482
Name:HORN, JAN PHILLIPPI (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JAN
Middle Name:PHILLIPPI
Last Name:HORN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 EISENHOWER DRIVE
Mailing Address - Street 2:710 CENTRAL PARK BUILDING 700
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406
Mailing Address - Country:US
Mailing Address - Phone:912-355-7065
Mailing Address - Fax:912-598-8358
Practice Address - Street 1:340 EISENHOWER DRIVE
Practice Address - Street 2:710 CENTRAL PARK BUILDING 700
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406
Practice Address - Country:US
Practice Address - Phone:912-355-7065
Practice Address - Fax:912-598-8358
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALCSW GA 002050103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist