Individual
JILLIAN POTTER-BONSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
20 S LIMESTONE ST STE 335, SPRINGFIELD, OH 45502-0003
(937) 346-8795
Mailing address
20 S LIMESTONE ST STE 335, SPRINGFIELD, OH 45502-0003
(937) 346-8795
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
S.1201070
OH
101YM0800X
Mental Health Counselor
S.1201070
OH
104100000X
Social Worker
S1201070
OH
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2433503
—
OH
Enumeration date
08/24/2015
Last updated
04/20/2021
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