Jill C Eilenberger PC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

C000269 Issued in NC

Legal business name

JILL C EILENBERGER PC

Practice address

1515 Mockingbird LN Ste 408
Jill C Eilenberger PC
Charlotte, NC 28209-3298

Phone

(704) 522-0291

Fax

(704) 522-0292

NPI assigned

Jun 4, 2006

Last updated

Jul 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Jill C Eilenberger, LCSW LMFT

Title

Psychotherapist President of the Co

Phone

(704) 522-0291

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1699713206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11692",
            "address_2": "JILL C EILENBERGER PC",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28220",
            "telephone_number": "704-522-0291",
            "fax_number": "704-522-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 408",
            "address_2": "JILL C EILENBERGER PC",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093298",
            "telephone_number": "704-522-0291",
            "fax_number": "704-522-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL C EILENBERGER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "EILENBERGER",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST PRESIDENT OF THE CO",
        "authorized_official_telephone_number": "704-522-0291",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LCSW LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "C000269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3025F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.