Provider Demographics
NPI:1861675183
Name:GURETSE, JILL R (MSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:R
Last Name:GURETSE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 ELINOR WAY
Mailing Address - Street 2:
Mailing Address - City:EAST GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18041-2146
Mailing Address - Country:US
Mailing Address - Phone:484-788-2285
Mailing Address - Fax:
Practice Address - Street 1:807 LAWN AVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1549
Practice Address - Country:US
Practice Address - Phone:215-257-6551
Practice Address - Fax:215-257-4008
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PACW0181541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)