Jill Minissa Maccormack, LICSW

NPI #1790086387 in North Providence, Rhode Island

Provider Information

NPI Number: 1790086387
Entity Type: Individual
Name: Jill Minissa Maccormack, LICSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: LICSW
Enumeration Date: Nov 12, 2010
Last Updated: Aug 27, 2015

Practice Location

Address: 200 HIGH SERVICE AVE
City: North Providence
State: Rhode Island
ZIP Code: 02904-5113
Phone: (401) 456-3000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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