Provider Demographics
NPI:1801436357
Name:HILLOCKS, JEHLISA (LMSW)
Entity type:Individual
Prefix:
First Name:JEHLISA
Middle Name:
Last Name:HILLOCKS
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 1:13110 CRUTCHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3207
Mailing Address - Country:US
Mailing Address - Phone:240-506-8647
Mailing Address - Fax:
Practice Address - Street 1:13400 EDGEMEADE RD
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-8088
Practice Address - Country:US
Practice Address - Phone:240-681-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25472104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker