Provider Demographics
NPI:1578993580
Name:STANTE, JILL MICHELE-REESE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:MICHELE-REESE
Last Name:STANTE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:JILL
Other - Middle Name:MICHELE
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-1282
Mailing Address - Country:US
Mailing Address - Phone:734-506-8565
Mailing Address - Fax:
Practice Address - Street 1:3 E MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160-1282
Practice Address - Country:US
Practice Address - Phone:734-506-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801091919104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker