Individual
JILL BLACKWELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCS, CCS, LCAS, NCC
Contact information
Practice address
536 SIGNAL HILL DRIVE EXTENSION, STATESVILLE, NC 28625
(704) 872-0234
(704) 818-1115
Mailing address
536 SIGNAL HILL DRIVE EXT, STATESVILLE, NC 28625-4391
(704) 872-0234
(704) 818-1115
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2135
NC
Other
Enumeration date
01/08/2007
Last updated
07/17/2012
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