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General NPI Number Information
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NPI Number | 1255884847
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Entity Type | Individual
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Provider Name | JANICE HILLEMAN L.C.S.W
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Gender | Female
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Dates
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Enumeration Date | 07/29/2016
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 203 CATHERINE TER
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City | FAIRFIELD
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State | CT
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Zip | 06824-6407
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Country | US
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Telephone | 516-524-2166
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Fax |
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Provider Business Mailing Address
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Address Line | 49 JOHN ST STE 102
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City | SOUTHPORT
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State | CT
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Zip | 06890-1484
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Country | US
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Telephone | 516-524-2166
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 009343
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License Number State | CT
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