JILL RENAE BOMSTAD LCPC
NPI 1497385785
Counselor - Professional in Springfield, IL
Active since January 25, 2020
5850 6TH STREET FRONTAGE RD E STE A, SPRINGFIELD, IL 62703(217) 529-5046 Get Directions Write a Review
About Jill Renae Bomstad Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JILL RENAE BOMSTAD LCPC (NPI 1497385785) is an individual professional provider in Springfield, Illinois, licensed in Illinois (180011696) and active in the NPI registry since January 2020.
NPPES Registry Identity
NPI1497385785
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJILL RENAE BOMSTADCredential: LCPC
Location Address5850 6TH STREET FRONTAGE RD E STE ASpringfield, IL 62703-5194
Mailing Address2516 W Harbauer LnSpringfield, IL 62702-3449 · (217) 816-3048
Phone(217) 529-5046
Sole ProprietorYes
Enumeration DateJanuary 25, 2020
Last NPPES UpdateOctober 6, 20232 updates tracked since enumeration
NPPES CertifiedOctober 6, 2023
✔ NPI 1497385785 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 180011696
5850 6TH STREET FRONTAGE RD E STE A, Springfield, IL 62703
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Social Worker (Clinical)
5850 6TH STREET FRONTAGE RD E STE A
SPRINGFIELD, IL 62703
SPRINGFIELD, IL 62703
Nurse Practitioner (Primary Care)
5850 6TH STREET FRONTAGE RD E STE A
SPRINGFIELD, IL 62703
SPRINGFIELD, IL 62703
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497385785, enumerated as an "individual" on January 25, 2020.
The provider is located at 5850 6TH STREET FRONTAGE RD E STE A SPRINGFIELD, IL 62703 and the phone number is (217) 529-5046.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
