Provider Demographics
NPI:1104337161
Name:VELEKKAKAN, JILLIAN G (LCSW)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:G
Last Name:VELEKKAKAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:G
Other - Last Name:APPLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4 FLINT LOCK CIR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-4911
Mailing Address - Country:US
Mailing Address - Phone:585-225-9720
Mailing Address - Fax:585-225-6898
Practice Address - Street 1:20 ARCAMPUS DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3630
Practice Address - Country:US
Practice Address - Phone:585-225-9720
Practice Address - Fax:585-225-6898
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085721-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical