Provider Demographics
NPI:1023527637
Name:HILL, JESSICA AVERY (LSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:AVERY
Last Name:HILL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-1218
Mailing Address - Country:US
Mailing Address - Phone:717-806-5050
Mailing Address - Fax:
Practice Address - Street 1:200 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-1218
Practice Address - Country:US
Practice Address - Phone:717-806-5050
Practice Address - Fax:717-806-5179
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW124723104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker