Provider Demographics
NPI:1871267393
Name:PARRILLO, JESSICA LINDSEY (PHD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LINDSEY
Last Name:PARRILLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 21ST ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20052-0049
Mailing Address - Country:US
Mailing Address - Phone:917-992-2576
Mailing Address - Fax:
Practice Address - Street 1:607 21ST ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20052-0049
Practice Address - Country:US
Practice Address - Phone:917-992-2576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1001703103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling