Provider Demographics
NPI:1053181578
Name:JARAMILLO, GIANNIL (LCSW)
Entity type:Individual
Prefix:
First Name:GIANNIL
Middle Name:
Last Name:JARAMILLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 262
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-0262
Mailing Address - Country:US
Mailing Address - Phone:551-223-1222
Mailing Address - Fax:
Practice Address - Street 1:100 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4713
Practice Address - Country:US
Practice Address - Phone:551-223-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-05
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC062819001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical