Derosas, Jillian

Derosas, Jillian is an individual health care provider with primary practice located at 846 Farmington Ave Ste 4 , West Hartford CT 06119-1554. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Derosas, Jillian can be contacted via phone (571) 427-0740.

Contact Information

Primary practice address
846 Farmington Ave Ste 4 West Hartford CT 06119-1554
Phone: (571) 427-0740
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 14069 Connecticut

Profile Details

NPI number 1679229132
LBN Legal business name Derosas, Jillian
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2022
Last updated May 31st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679229132 NPPES
Louisiana MEDICAID 1701033

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