Organization Name: | JILL JOHNSON BARDSLEY LICSW, BCD |
NPI Number: | 1992116966 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JILL A. JOHNSON BARDSLEY (OWNER/ MANAGER) |
Mailing Address: | 51 E Main St Suite 5 Warner |
State: | NH US |
Postal Code: | 032784408 |
Phone Number: | 6037486103 |
Fax Number: | 6032255757 |
NPI Enumeration Date: | 05/13/2014 |
NPI Last Update Date: | 05/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 59 LICSW |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |