MEDICARE: MRS. JILL WHITE-HUFFMAN 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
1	101YM0800X	Mental Health Counselor	7825	NC

General Provider Information

NPI Number	:	1255644407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JILL WHITE-HUFFMAN LPC

Provider Business Mailing Address
First Line	:	3904 LAWNDALE DR
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455
Country	:	US
Telephone Number	:	336-855-1860
Fax Number	:

Provider Business Practice Location Address
First Line	:	1921 BOULEVARD ST STE D
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-4560
Country	:	US
Telephone Number	:	336-387-6161
Fax Number	:

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

Provider Enumeration Date	:	07/16/2010
Last Update Date	:	11/16/2015

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