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General NPI Number Information
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NPI Number | 1902625767
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Entity Type | Individual
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Provider Name | JILL O'GARA LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 61 INNERBELT RD
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City | SOMERVILLE
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State | MA
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Zip | 02143-4416
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Country | US
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Telephone | 508-861-9322
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Fax |
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Provider Business Mailing Address
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Address Line | 102 HOOKER ST
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City | ALLSTON
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State | MA
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Zip | 02134-1233
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Country | US
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Telephone | 703-598-7928
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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 | 228561
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License Number State |
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