Provider Demographics
NPI:1922751577
Name:SINGH, JYLLAINE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:JYLLAINE
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MISS
Other - First Name:JYLLAINE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3736 COLEBROOK RD APT 2
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-8922
Mailing Address - Country:US
Mailing Address - Phone:717-649-1254
Mailing Address - Fax:
Practice Address - Street 1:3736 COLEBROOK RD APT 2
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-8922
Practice Address - Country:US
Practice Address - Phone:717-649-1254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW136599104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker