Provider Demographics
NPI:1831363803
Name:FINE, JILL S (MSED, LPC,CAC)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:S
Last Name:FINE
Suffix:
Gender:F
Credentials:MSED, LPC,CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 COMMERCE LOOP
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642
Mailing Address - Country:US
Mailing Address - Phone:724-382-4628
Mailing Address - Fax:724-515-7340
Practice Address - Street 1:2000 COMMERCE LOOP
Practice Address - Street 2:SUITE 2200
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642
Practice Address - Country:US
Practice Address - Phone:724-382-4628
Practice Address - Fax:724-515-7340
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA004822101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)