Jill C Eilenberger, LCSW, LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C000269 Issued in NC

Practice address

4108 Park Rd
Ste 322
Charlotte, NC 28209-2259

Phone

(704) 591-0648

Fax

(704) 943-0768

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 30, 2016 through Nov 30, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1992722631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11692",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282201692",
            "telephone_number": "704-591-0648",
            "fax_number": "704-943-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 PARK RD",
            "address_2": "STE 322",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092259",
            "telephone_number": "704-591-0648",
            "fax_number": "704-943-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EILENBERGER",
        "first_name": "JILL",
        "middle_name": "C",
        "name_prefix": "Miss",
        "credential": "LCSW, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C000269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3025F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Eidem, PA
• Rachelle M. Eiden, PA-C
• Eight One Four Labs LLC
• Maxine Semaneh Eikani, MD
• Cullan B Eikenberry, LCSWA
• Michelle Einson, PSYD
• Einstein Concepts LLC, Dba American Homecare Carolina
• Scott W Eiselt, PT
• Tracy Estelle Eisenbeis, PT
• Adva Tal Eisenberg, MD

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.