Jillian Elise Holtz Damron, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

01738 Issued in MN

Practice address

5625 Cenex Dr
Inver Grove Heights, MN 55077-1724

Phone

(651) 552-2600

Fax

(651) 552-2614

NPI assigned

Oct 1, 2013

Last updated

May 3, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1245667633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-552-2600",
            "fax_number": "651-552-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 CENEX DR",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550771724",
            "telephone_number": "651-552-2600",
            "fax_number": "651-552-2614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7064 W Point Douglas Rd S Ste 201",
            "address_purpose": "LOCATION",
            "city": "Cottage Grove",
            "state": "MN",
            "postal_code": "55016",
            "country_code": "US",
            "telephone_number": "651-458-5224",
            "fax_number": "651-458-5310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMRON",
        "first_name": "JILLIAN",
        "middle_name": "ELISE HOLTZ",
        "name_prefix": "Mrs.",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1898226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "01738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Inver Grove Heights, MN
• Providers in Inver Grove Heights, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.