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Organization
JILLIAN L FORMAN LMHC NCC PLLC
Active
Organization
JILLIAN L FORMAN LMHC NCC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN L FORMAN LMHC NCC (OWNER)
(607) 281-8815
Entity
Organization
Contact information
Practice address
2 S MAIN ST, SUITE #3, ANDOVER, NY 14806
(607) 281-8815
Mailing address
67 W UNIVERSITY ST, ALFRED, NY 14802-1136
(607) 281-8815
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/26/2026
Last updated
08/26/2026
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