Provider Demographics
NPI:1093163545
Name:LAMORIE, JILL A (DSW, LCSW)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:A
Last Name:LAMORIE
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:DR
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:HARRINGTON-LAMORIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DSW, LCSW
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:OCCOQUAN
Mailing Address - State:VA
Mailing Address - Zip Code:22125-0665
Mailing Address - Country:US
Mailing Address - Phone:703-490-9681
Mailing Address - Fax:703-490-9682
Practice Address - Street 1:204 ELLICOTT ST
Practice Address - Street 2:
Practice Address - City:OCCOQUAN
Practice Address - State:VA
Practice Address - Zip Code:22125-7714
Practice Address - Country:US
Practice Address - Phone:703-490-9681
Practice Address - Fax:703-490-9682
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904008251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical