Provider Demographics
NPI:1750951067
Name:JORGENSEN, JILL NOELLE (LPC)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:NOELLE
Last Name:JORGENSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 NE MAPLE LEAF CT
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-7753
Mailing Address - Country:US
Mailing Address - Phone:208-241-0389
Mailing Address - Fax:
Practice Address - Street 1:810 NE MAPLE LEAF CT
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-7753
Practice Address - Country:US
Practice Address - Phone:208-241-0389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101Y00000XBehavioral Health & Social Service ProvidersCounselor