Provider Demographics
NPI:1770681488
Name:BABBITT, JILL DARLENE (LCSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:DARLENE
Last Name:BABBITT
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 1:299 I ST STE 10
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-4378
Mailing Address - Country:US
Mailing Address - Phone:707-465-5936
Mailing Address - Fax:707-465-5936
Practice Address - Street 1:299 I ST STE 10
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-4378
Practice Address - Country:US
Practice Address - Phone:707-465-5936
Practice Address - Fax:707-465-5936
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 199191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical