Provider Demographics
NPI:1013235779
Name:ROBERTS, JILL S (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:S
Last Name:ROBERTS
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 1:610 STATE ROUTE 116
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:IL
Mailing Address - Zip Code:61548-7729
Mailing Address - Country:US
Mailing Address - Phone:309-840-3885
Mailing Address - Fax:
Practice Address - Street 1:610 STATE ROUTE 116
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:IL
Practice Address - Zip Code:61548-7729
Practice Address - Country:US
Practice Address - Phone:309-840-3885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490125971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical