Jillian Nicole Carlson
Individual provider Active NPI Social Worker · Plainville, CT
NPI 1972022820 · NPPES record last updated Sep 12, 2017
Key facts
- NPI
- 1972022820
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 3945 (CT)
- Practice address
- 74 East St
Plainville, CT 06062-2367 - Phone
- (860) 793-3500
- NPI assigned
- Sep 12, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3945 | CT | MD | Mental Health Counselor |
Interoperability endpoints
- jillian.carlson.p1@direct.wheelerclinic.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 3945 | CT | Yes |
Addresses
Primary practice location
74 East St
Plainville, CT 06062-2367
Mailing address
74 East Street
Plainville, CT 06062
Other providers in Plainville, CT
- Cara Newton, LCSW, LLC
- Robert Carangelo
- Mitchell Lynwood Cardillo
- Dalila Cardona
- Nicole A Carlone
- Meagan Casey Carlson
- Kailyn Carolan
- Bethany Anne Carr
- Hannah Carroccia
- Carolyn Jean Cavaliere
All providers in Plainville, CT · Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.