MEDICARE: JILLIAN DEBENEDETTO LCSW

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	390200000X	Student in an Organized Health Care Education/Training Program
2	1041C0700X	Clinical Social Worker	44SC06143700	NJ

General Provider Information

NPI Number	:	1073861209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN DEBENEDETTO LCSW

Provider Business Mailing Address
First Line	:	108 HIGHLAND AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5802
Country	:	US
Telephone Number	:	732-610-3238
Fax Number	:

Provider Business Practice Location Address
First Line	:	FORT HEALTH MEDICAL GROUP 613 WASHING BLVD.
Second Line	:	#1297
City	:	JERSEY CITY
State	:	NJ
Zip	:	10314-1509
Country	:	US
Telephone Number	:	201-208-2616
Fax Number	:

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

Provider Enumeration Date	:	08/20/2012
Last Update Date	:	12/22/2022

Similar Medicare Providers

1033257191 — MRS. DEVIN LE SLP
Practice Location Address:

10314 CAPE HATTERAS WAY
MISSOURI CITY, TX
77459-2441

Practice Phone: 713-668-6690
Practice Fax:

1760654271 — MS. LISA DIAN BUTTERFIELD LPN
Practice Location Address:

10314 HILLCREST RD APT 21
KANSAS CITY, MO
64134-4423

Practice Phone: 417-549-0002
Practice Fax:

1366687949 — SOUND SPEECH THERAPY PC
Practice Location Address:

10314 CAPE HATTERAS WAY
MISSOURI CITY, TX
77459-2441

Practice Phone: 281-871-1428
Practice Fax:

1659649861 — SOUND SPEECH THERAPY P.C
Practice Location Address:

10314 CAPE HATTERAS WAY
MISSOURI CITY, TX
77459-2441

Practice Phone: 281-871-1428
Practice Fax:

1487706792 — MS. SHEILA CRISTINA SANTIAGO LCSW
Practice Location Address:

19 VEDDER AVE
STATEN ISLAND, NY
10314-1509

Practice Phone: 718-370-2975
Practice Fax: 718-494-7836

1194001644 — DONNA TETA R.N.
Practice Location Address:

19 VEDDER AVE
STATEN ISLAND, NY
10314-1509

Practice Phone: 718-370-2975
Practice Fax:

Directions to “ JILLIAN DEBENEDETTO LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.