MEDICARE: MS. JILL FRESHOUR LCSW

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	1041C0700X	Clinical Social Worker	34005809A	IN

General Provider Information

NPI Number	:	1720077654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JILL FRESHOUR LCSW

Provider Business Mailing Address
First Line	:	PO BOX 392552
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9500
Country	:	US
Telephone Number	:	604-839-0812
Fax Number	:

Provider Business Practice Location Address
First Line	:	3512 STELLHORN RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-4631
Country	:	US
Telephone Number	:	260-483-9081
Fax Number	:

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

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	05/23/2024

Similar Medicare Providers

1962490839 — MRS. PEGGY A RYAN APRN,BC,ANP
Practice Location Address:

3512 STELLHORN RD
FORT WAYNE, IN
46815-4631

Practice Phone: 260-483-9081
Practice Fax:

1972584043 — VAHID-DAVID SEDAGHAT M.D.
Practice Location Address:

3512 STELLHORN RD
FORT WAYNE, IN
46815-4631

Practice Phone: 260-483-9081
Practice Fax: 260-483-9196

1497730535 — NINA D SCOTT NP
Practice Location Address:

3512 STELLHORN RD , SUITE 100
FORT WAYNE, IN
46815-4631

Practice Phone: 260-483-9081
Practice Fax: 260-483-9196

1932201175 — MRS. FERN O MCHENRY NP
Practice Location Address:

3512 STELLHORN RD
FORT WAYNE, IN
46815-4631

Practice Phone: 260-483-9081
Practice Fax: 260-483-9196

1093811606 — MRS. GAYLE BEVILL-DADA
Practice Location Address:

3514 STELLHORN RD
FORT WAYNE, IN
46815-4631

Practice Phone: 260-492-5500
Practice Fax: 260-422-1555

1003940990 — MRS. LHYRA DAWIS MAYORALGO PT
Practice Location Address:

3512 STELLHORN RD
FORT WAYNE, IN
46815-4631

Practice Phone: 260-483-9081
Practice Fax:

Directions to “ MS. JILL FRESHOUR LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.