Provider Demographics
NPI:1477674901
Name:SEIPEL, JILL MARIE (MSSA, LICSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:SEIPEL
Suffix:
Gender:F
Credentials:MSSA, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 116TH AVE NE
Mailing Address - Street 2:SUITE 223
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3010
Mailing Address - Country:US
Mailing Address - Phone:425-455-6784
Mailing Address - Fax:425-646-9759
Practice Address - Street 1:1611 116TH AVE NE
Practice Address - Street 2:SUITE 223
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3010
Practice Address - Country:US
Practice Address - Phone:425-455-6784
Practice Address - Fax:425-646-9759
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000042911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical