| Doctor Name: | MRS. JILL MARIE GOLDSWORTHY |
| NPI Number: | 1003916149 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 18024 |
| Business Practice Address: | 10045 W Lisbon Ave Suite 221 Wauwatosa, WI - 532222446 |
| Business Phone Number: | 4143587146 |
| Business Fax Number: | |
| Mailing Address: | 8008 Gina Dr, RACINE |
| State: | WI |
| Postal Code: | 534062510 |
| Phone Number: | 6083472776 |
| Fax Number: | |
| NPI Enumeration Date: | 09/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 18024 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |