Provider Demographics
NPI:1922543065
Name:HOLGUIN, JILLIAN (LCSW)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:HOLGUIN
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 1:36 SOCIETY HILL WAY
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3800
Mailing Address - Country:US
Mailing Address - Phone:201-546-0909
Mailing Address - Fax:862-701-2683
Practice Address - Street 1:36 SOCIETY HILL WAY
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3800
Practice Address - Country:US
Practice Address - Phone:201-546-0909
Practice Address - Fax:862-701-2683
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057072001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical