Provider Demographics
NPI:1912272956
Name:SPRINGER, JILL SABRA (LMFT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:SABRA
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 LAKE WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:CT
Mailing Address - Zip Code:06249-1918
Mailing Address - Country:US
Mailing Address - Phone:860-608-8524
Mailing Address - Fax:
Practice Address - Street 1:18 LEDGEBROOK DR
Practice Address - Street 2:SUITE E
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250-1664
Practice Address - Country:US
Practice Address - Phone:860-608-8524
Practice Address - Fax:860-642-9955
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001058106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist