Provider Demographics
NPI:1255884847
Name:HILLEMAN, JANICE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:
Last Name:HILLEMAN
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 1:49 JOHN ST
Mailing Address - Street 2:STE 102
Mailing Address - City:SOUTHPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06890-1484
Mailing Address - Country:US
Mailing Address - Phone:516-524-2166
Mailing Address - Fax:
Practice Address - Street 1:203 CATHERINE TER
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6407
Practice Address - Country:US
Practice Address - Phone:516-524-2166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0093431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical