Provider Demographics
NPI:1265846497
Name:TAYLOR, JILL MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:TAYLOR
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 1:744 E LINCOLN HWY
Mailing Address - Street 2:SUITE 420
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-3590
Mailing Address - Country:US
Mailing Address - Phone:610-383-5635
Mailing Address - Fax:610-383-6854
Practice Address - Street 1:744 E LINCOLN HWY
Practice Address - Street 2:SUITE 420
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-3590
Practice Address - Country:US
Practice Address - Phone:610-383-5635
Practice Address - Fax:610-383-6854
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0180321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical