Individual
JILLIAN DEROSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
846 FARMINGTON AVE STE 4, WEST HARTFORD, CT 06119-1554
(571) 427-0740
Mailing address
43 HILLTOP DR, WEST HARTFORD, CT 06107-1434
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14069
CT
1041S0200X
School Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1701033
—
LA
Enumeration date
02/23/2022
Last updated
05/31/2024
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