Provider Demographics
NPI:1801989686
Name:FRANCE, JILL BARBRO (MED, LPC)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:BARBRO
Last Name:FRANCE
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 N NEVADA AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-5021
Mailing Address - Country:US
Mailing Address - Phone:719-641-3435
Mailing Address - Fax:719-836-4835
Practice Address - Street 1:614 N NEVADA AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-5021
Practice Address - Country:US
Practice Address - Phone:719-641-3435
Practice Address - Fax:719-836-4835
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1051101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO081709Medicaid