Provider Demographics
NPI:1265568976
Name:VAN HORNE, JILL WEIDKNECHT (LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:WEIDKNECHT
Last Name:VAN HORNE
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 WILLIAMSON RD
Mailing Address - Street 2:
Mailing Address - City:HORSE SHOE
Mailing Address - State:NC
Mailing Address - Zip Code:28742-5779
Mailing Address - Country:US
Mailing Address - Phone:609-713-1957
Mailing Address - Fax:
Practice Address - Street 1:68 GROVE ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3204
Practice Address - Country:US
Practice Address - Phone:828-258-0031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4284101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional