Provider Demographics
NPI:1033255948
Name:FRIZZELL, JILL (LCSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:FRIZZELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 9TH ST
Mailing Address - Street 2:A-4
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6273
Mailing Address - Country:US
Mailing Address - Phone:707-362-1709
Mailing Address - Fax:
Practice Address - Street 1:632 9TH ST
Practice Address - Street 2:A-4
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6273
Practice Address - Country:US
Practice Address - Phone:707-362-1709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA246981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical