Colegrove, Jill Marie

Colegrove, Jill Marie is an sole proprietor health care provider with primary practice located at 1460 35Th Ave , Columbus NE 68601-4731. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Colegrove, Jill Marie can be contacted via phone (402) 562-6767.

Contact Information

Primary practice address
1460 35Th Ave Columbus NE 68601-4731
Phone: (402) 562-6767
Fax: (402) 562-6770
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2761 Nebraska
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 1459 Nebraska
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 685 Nebraska
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 550 Nebraska

Profile Details

NPI number 1992882203
LBN Legal business name Colegrove, Jill Marie
Credentials LMHP, LPC, PLADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Aug 4th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992882203 NPPES
Nebraska MEDICAID 10025329800
Nebraska Other 85470
Nebraska Other 244754

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