Provider Demographics
NPI:1104177237
Name:HILLIARD, JASMINE R (LCSW)
Entity type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:R
Last Name:HILLIARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 WEBBS LN
Mailing Address - Street 2:APT A23
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-5450
Mailing Address - Country:US
Mailing Address - Phone:203-314-4251
Mailing Address - Fax:
Practice Address - Street 1:260 CHAPMAN RD
Practice Address - Street 2:SUITE 100B
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5490
Practice Address - Country:US
Practice Address - Phone:302-292-1334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00011821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical