Provider Demographics
NPI:1710361944
Name:JONES, JILL PIETRZAKOWSKI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:PIETRZAKOWSKI
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:PIETRZAKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:277 GA-74 N
Mailing Address - Street 2:#306
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269
Mailing Address - Country:US
Mailing Address - Phone:678-383-1210
Mailing Address - Fax:
Practice Address - Street 1:277 GA-74 N
Practice Address - Street 2:#306
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:678-383-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0054481041C0700X
CA224931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical