Provider Demographics
NPI:1114604725
Name:PHINNEY, JILLIAN (LSW)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:PHINNEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 LAKEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-8976
Mailing Address - Country:US
Mailing Address - Phone:412-874-1499
Mailing Address - Fax:
Practice Address - Street 1:4284 WILLIAM FLYNN HWY STE 305
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-1440
Practice Address - Country:US
Practice Address - Phone:412-650-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137307104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker