Provider Demographics
NPI:1568486470
Name:BARRETT, JILL C (LCSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:C
Last Name:BARRETT
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 1:21 RONA ST
Mailing Address - Street 2:
Mailing Address - City:INTERLAKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4360
Mailing Address - Country:US
Mailing Address - Phone:732-456-0991
Mailing Address - Fax:
Practice Address - Street 1:81 OAK HILL RD
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5747
Practice Address - Country:US
Practice Address - Phone:732-456-0991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL051594001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical