Provider Demographics
NPI:1649963323
Name:GINSBERG, JILLIAN MICHELLE (LMSW)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:MICHELLE
Last Name:GINSBERG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 HARFORD RD UNIT 3623
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-7509
Mailing Address - Country:US
Mailing Address - Phone:410-343-9201
Mailing Address - Fax:
Practice Address - Street 1:4901 HARFORD RD UNIT 3623
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-7509
Practice Address - Country:US
Practice Address - Phone:410-343-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30006104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker