MEDICARE: JILL K MURTAUGH LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	58686	TX

General Provider Information

NPI Number	:	1912735754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL K MURTAUGH LMSW

Provider Business Mailing Address
First Line	:	6430 VISTA BUTTE
Second Line	:
City	:	WINDCREST
State	:	TX
Zip	:	78239-2755
Country	:	US
Telephone Number	:	262-442-5159
Fax Number	:

Provider Business Practice Location Address
First Line	:	5835 CALLAGHAN RD STE 203
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1224
Country	:	US
Telephone Number	:	210-239-8756
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2024
Last Update Date	:	07/23/2024

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