Provider Demographics
NPI:1932125739
Name:BALAGUR-CONN, B. JILL L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:B. JILL
Middle Name:L
Last Name:BALAGUR-CONN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 MANDARIN FLYWAY
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4075
Mailing Address - Country:US
Mailing Address - Phone:512-528-1980
Mailing Address - Fax:512-528-9464
Practice Address - Street 1:1490 E WHITESTONE BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2274
Practice Address - Country:US
Practice Address - Phone:512-663-9950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical