Provider Demographics
NPI:1699091900
Name:MCVANE, JILL ELIZABETH (MED, LMHC)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ELIZABETH
Last Name:MCVANE
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:E
Other - Last Name:SEELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 ASH ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2725
Mailing Address - Country:US
Mailing Address - Phone:781-835-7736
Mailing Address - Fax:
Practice Address - Street 1:21 ASH ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2725
Practice Address - Country:US
Practice Address - Phone:781-835-7736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool