Provider Demographics
NPI:1639222417
Name:WEINSTEIN, JILL AMY (LPC)
Entity type:Individual
Prefix:MR
First Name:JILL
Middle Name:AMY
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3750 PALLADIAN VILLAGE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-8200
Mailing Address - Country:US
Mailing Address - Phone:770-592-0566
Mailing Address - Fax:770-592-0566
Practice Address - Street 1:3750 PALLADIAN VILLAGE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-8200
Practice Address - Country:US
Practice Address - Phone:770-592-0566
Practice Address - Fax:770-592-0566
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004708101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health