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NPI Code Detail

MEDICARE: JAIME NICHOLE SHILL LPC

MEDICARE: JAIME NICHOLE SHILL LPC
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
1101Y00000XCounselor0701009004VA

General Provider Information

NPI Number : 1134742489
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIME NICHOLE SHILL LPC
Provider Business Mailing Address
First Line : 8310 MIDLOTHIAN TPKE
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23235-5163
Country : US
Telephone Number : 804-447-6382
Fax Number : 804-447-6383
Provider Business Practice Location Address
First Line : 8310 MIDLOTHIAN TPKE
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23235-5163
Country : US
Telephone Number : 804-447-6382
Fax Number : 804-447-6383
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2020
Last Update Date : 05/21/2020

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Directions to “ JAIME NICHOLE SHILL LPC” Practice Location

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