Fischberg, Jill Leslie

Fischberg, Jill Leslie is an sole proprietor health care provider with primary practice located at 6170 53Rd Ave E , Bradenton FL 34203-9721. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Fischberg, Jill Leslie can be contacted via phone (941) 468-4567.

Contact Information

Primary practice address
6170 53Rd Ave E Bradenton FL 34203-9721
Phone: (941) 468-4567
Fax: (941) 621-6226
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH 10788 Florida
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X MH 10788 Florida
Behavioral Health & Social Service Providers / Counselor 101Y00000X MH 10788 Florida
Behavioral Health & Social Service Providers / Professional 101YP2500X MH 10788 Florida

Profile Details

NPI number 1104882679
LBN Legal business name Fischberg, Jill Leslie
Credentials LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2006
Last updated Aug 4th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104882679 NPPES
Florida MEDICAID 003784400

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