Individual provider Active NPI

Jillian L Kirschner, PHD

  • Counselor
  • Woodstock, GA
National Provider Identifier
1558894782
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
#0606 Issued in GA
Practice address
655 Molly LN
Suite 150
Woodstock, GA 30189-6503
Phone
(678) 697-0422
NPI assigned
Apr 5, 2017
Last updated
Apr 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X #0606 GA Primary

Addresses

Primary practice location

655 Molly LN
Suite 150
Woodstock, GA 30189-6503

Mailing address

132 Maxwell Ave SW
Marietta, GA 30064-3212
Phone (678) 697-0422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
#0606GAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1558894782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 MAXWELL AVE SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300643212",
            "telephone_number": "678-697-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 MOLLY LN",
            "address_2": "SUITE 150",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896503",
            "telephone_number": "678-697-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHNER",
        "first_name": "JILLIAN",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "#0606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.