Favata, Jill C

Favata, Jill C is an sole proprietor health care provider with primary practice located at 2909 Bent Ave The Healing Center, Cheyenne WY 82001-2742. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Favata, Jill C can be contacted via phone (307) 286-5279.

Contact Information

Primary practice address
2909 Bent Ave The Healing Center Cheyenne WY 82001-2742
Phone: (307) 286-5279
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 910 Wyoming
Behavioral Health & Social Service Providers / Counselor 101Y00000X 910 Wyoming

Profile Details

NPI number 1972587319
LBN Legal business name Favata, Jill C
Credentials M.S. ED, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2005
Last updated Jun 30th, 2009 - about 15 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 1972587319 NPPES
Wyoming Other 312408 BS

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