| Jill Osborne, Lpc, Llc | |
|
1269 Parker Rd Se Conyers GA 30094-5957 | |
| (404) 234-0546 | |
| Not Available |
| Full Name | Jill Osborne, Lpc, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1269 Parker Rd Se, Conyers, Georgia |
| Authorized Official Name and Position | Kimberly J Osborne (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 4042340546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill Osborne, Lpc, Llc 1269 Parker Rd Se Conyers GA 30094-5957 Ph: (404) 234-0546 | Jill Osborne, Lpc, Llc 1269 Parker Rd Se Conyers GA 30094-5957 Ph: (404) 234-0546 |
| NPI Number | 1952835704 |
|---|---|
| Provider Enumeration Date | 04/19/2017 |
| Last Update Date | 04/19/2017 |
| Medicare PECOS PAC ID | 9638604168 |
|---|---|
| Medicare Enrollment ID | O20241121000419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952835704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC006170 (Georgia) | Primary |
| Provider Name | Kimberly Jill Osborne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629378955 PECOS PAC ID: 0547795072 Enrollment ID: I20241121000573 |
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