MEDICARE: JILL BRICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149027407	IL
2	1041C0700X	Clinical Social Worker	9493	TN

General Provider Information

NPI Number	:	1023835691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL BRICK

Provider Business Mailing Address
First Line	:	4041 SADIE GRACE WAY
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37042-1222
Country	:	US
Telephone Number	:	815-280-9439
Fax Number	:

Provider Business Practice Location Address
First Line	:	4041 SADIE GRACE WAY
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37042-1222
Country	:	US
Telephone Number	:	815-280-9439
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	03/18/2026

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Directions to “ JILL BRICK ” Practice Location

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