Provider Demographics
NPI:1336795921
Name:BARRICK, JILL M (LICSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:BARRICK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:M
Other - Last Name:SCHAGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OLSZEWSKI
Mailing Address - Street 1:1248 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-8752
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9600 VETERANS DR SW
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-0003
Practice Address - Country:US
Practice Address - Phone:360-790-2535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-10
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALW60846141OtherDEPARTMENT OF HEALTH