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General NPI Number Information
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NPI Number | 1659137180
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Entity Type | Individual
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Provider Name | JILLIAN BETZ LSW
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Gender | Female
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 111 W WATER ST
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City | TOMS RIVER
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State | NJ
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Zip | 08753-6407
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Country | US
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Telephone | 732-679-4500
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Fax |
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Provider Business Mailing Address
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Address Line | CENTER FOR GROWTH 360 WEST AVE.
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City | OCEAN CITY
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State | NJ
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Zip | 08226
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Country | US
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Telephone | 267-324-9564
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06795800
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License Number State | NJ
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