Provider Demographics
NPI:1962980524
Name:TAPPER, JILL J (LICSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:J
Last Name:TAPPER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 BEACH RD UNIT A1
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-2253
Mailing Address - Country:US
Mailing Address - Phone:978-465-0851
Mailing Address - Fax:
Practice Address - Street 1:135 BEACH RD UNIT A1
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MA
Practice Address - Zip Code:01952-2253
Practice Address - Country:US
Practice Address - Phone:978-465-0851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-05
Last Update Date:2018-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1008621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty