Jillian Kimberly Easttey, LMSW-CC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

MC24011 Issued in ME

Practice address

75 John Roberts Rd Ste B8
South Portland, ME 04106-6964

Phone

(207) 775-4151

NPI assigned

Sep 18, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1275360760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 JOHN ROBERTS RD STE B8",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066964",
            "telephone_number": "207-775-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 JOHN ROBERTS RD STE B8",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066964",
            "telephone_number": "207-775-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTTEY",
        "first_name": "JILLIAN",
        "middle_name": "KIMBERLY",
        "credential": "LMSW-CC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC24011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fawn Rae Dunphy, D.C.
• Caitlyn Beth Durant, RN, BSN
• Mackenzie Ireland Dwyer, PA-C
• Bruce Ashley Dyer, L.A.D.C.
• Easter Seals Maine, Inc
• Gabrielle Eberly
• Echo Imaging Solutions LLC
• Jerrold C. Edelberg, PH.D.
• William Saunders Edgar, ATC
• Janet Efron, LCSW

• Clinical Social Worker in South Portland, ME
• Providers in South Portland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.