Jill M Paulk, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00009448 Issued in WA

Practice address

884 West Park Avenue
Port Townsend, WA 98368

Phone

(360) 385-0321

Fax

(360) 379-5534

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Madrona Institute of Washington

  • Addiction (Substance Use Disorder) Counselor
  • Port Townsend, WA
  • NPI 1154410876
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1003977463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 LEPRECHAUN LANE",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "98362",
            "telephone_number": "360-457-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 WEST PARK AVENUE",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "98368",
            "telephone_number": "360-385-0321",
            "fax_number": "360-379-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULK",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC01167500",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR017066",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00009448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Parakletos, RN
• Molly B Parker, M.D.
• Reina HJ Parker, MD
• Catherine Anne Parkman, M.D.
• Partners in Well-Being, P.C., Inc.
• Peninsula Homecare Cooperative
• Richard Paul Perez, RPT
• Leeann Bridgett Peterson
• Matthew D. Petta, CRNA
• Elaine Phillips, ANP

• Clinical Social Worker in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.