Provider Demographics
NPI:1053524397
Name:MCELLIGOTT, JILL (LSW)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:MCELLIGOTT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:RAGOZZINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:303 W LANCASTER AVE
Mailing Address - Street 2:# 2B
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087
Mailing Address - Country:US
Mailing Address - Phone:610-322-8017
Mailing Address - Fax:
Practice Address - Street 1:303 W LANCASTER AVE
Practice Address - Street 2:# 2B
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087
Practice Address - Country:US
Practice Address - Phone:610-322-8017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA012580SW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical