Humphrey, Jillian Michael

Humphrey, Jillian Michael is an sole proprietor health care provider with primary practice located at 452 Goose Pond Rd , Morganfield KY 42437-5970. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Humphrey, Jillian Michael can be contacted via phone (270) 285-2265.

Contact Information

Primary practice address
452 Goose Pond Rd Morganfield KY 42437-5970
Phone: (270) 285-2265
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 272718 Kentucky

Profile Details

NPI number 1972070241
LBN Legal business name Humphrey, Jillian Michael
Credentials BCBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2018
Last updated Oct 2nd, 2023 - about 3 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 1972070241 NPPES
Kentucky MEDICAID 7100844780

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