Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jill Elizabeth Surine

Individual provider Mental Health Counselor · NPI 1790317667

Jill Elizabeth Surine is a Mental Health Counselor in Fort Wayne, Indiana. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

909 E State Blvd
Fort Wayne, IN 46805-3458
Phone: (260) 481-2700
Fax: (260) 481-2838
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1790317667
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 10, 2020
Last updated in NPPESFebruary 10, 2020
Certification dateFebruary 10, 2020

Other providers in Fort Wayne