Healthcare Provider Details

I. General information

NPI: 1992149520
Provider Name (Legal Business Name): JILL I HAAR MA, LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 22ND ST
TOLEDO OH
43604-2706
US

IV. Provider business mailing address

3909 WOODLEY RD
TOLEDO OH
43606-1169
US

V. Phone/Fax

Practice location:
  • Phone: 419-241-6191
  • Fax:
Mailing address:
  • Phone: 419-479-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE1200164-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberOH1412626
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: