Healthcare Provider Details

I. General information

NPI: 1588900021
Provider Name (Legal Business Name): JILL ELIZABETH MAROSCIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2013
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 12TH AVE S
SEATTLE WA
98144-2712
US

IV. Provider business mailing address

2727 E CAMELBACK RD APT 321
PHOENIX AZ
85016-4475
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-2400
  • Fax: 206-621-4434
Mailing address:
  • Phone: 815-826-0036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLW61565087
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW13646
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8504-C
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18829
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149020716
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: