Provider Demographics
NPI:1932953213
Name:PAPANEK, JILL (LCSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:PAPANEK
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 1:100 MAIN STREET N, PMB 219
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-3840
Mailing Address - Country:US
Mailing Address - Phone:203-521-9977
Mailing Address - Fax:
Practice Address - Street 1:519 HERITAGE RD STE 2A5
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-6694
Practice Address - Country:US
Practice Address - Phone:203-568-5923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7004104100000X
CT151661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker