Provider Demographics
NPI:1588152821
Name:D'ORNELLAS-LACOMBE, JILLIAN (LMFT)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:D'ORNELLAS-LACOMBE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:D'ORNELLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:361 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 CROOKED HILL RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1039
Practice Address - Country:US
Practice Address - Phone:631-286-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001327106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist