Provider Demographics
NPI:1841347127
Name:SAYWARD, JILL M (LCSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:SAYWARD
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 1:19 MISTY KNL
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7754
Mailing Address - Country:US
Mailing Address - Phone:617-827-6629
Mailing Address - Fax:
Practice Address - Street 1:271 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-4506
Practice Address - Country:US
Practice Address - Phone:508-224-8041
Practice Address - Fax:508-224-7787
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2134091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA213409OtherL.C.S.W.