Provider Demographics
NPI:1780278986
Name:AGUILAR, JILL ANGELIQUE (LPC-S)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ANGELIQUE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:ANGELIQUE
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2916 MONTELL CT
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-6042
Mailing Address - Country:US
Mailing Address - Phone:214-457-8997
Mailing Address - Fax:
Practice Address - Street 1:2916 MONTELL CT
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-6042
Practice Address - Country:US
Practice Address - Phone:214-457-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-27
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2538101YP2500X
TX66105101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional