Provider Demographics
NPI:1902127129
Name:YANG, JILL B (LCMHC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:B
Last Name:YANG
Suffix:
Gender:
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 MIDLAND RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-2100
Mailing Address - Country:US
Mailing Address - Phone:910-603-7349
Mailing Address - Fax:980-265-0289
Practice Address - Street 1:1475 MIDLAND RD UNIT 3
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-2100
Practice Address - Country:US
Practice Address - Phone:910-603-7349
Practice Address - Fax:980-265-0289
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional