Provider Demographics
NPI:1528294543
Name:HUNSICKER, JILL MARIE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:MARIE
Last Name:HUNSICKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:THURMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:935 BAY RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3510
Mailing Address - Country:US
Mailing Address - Phone:413-230-3949
Mailing Address - Fax:
Practice Address - Street 1:421 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-9764
Practice Address - Country:US
Practice Address - Phone:413-584-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW-11051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical