Provider Demographics
NPI:1629607981
Name:JILL ESSERY, LCSW LLC
Entity Type:Organization
Organization Name:JILL ESSERY, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESSERY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-575-2272
Mailing Address - Street 1:46 N CENTRAL AVE # C-3
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1864
Mailing Address - Country:US
Mailing Address - Phone:917-575-2272
Mailing Address - Fax:
Practice Address - Street 1:46 N CENTRAL AVE # C-3
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1864
Practice Address - Country:US
Practice Address - Phone:917-575-2272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)