Provider Demographics
NPI:1033298450
Name:BRILL, JONATHAN HENRY (MSW)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:HENRY
Last Name:BRILL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 BLISS ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2605
Mailing Address - Country:US
Mailing Address - Phone:413-586-1543
Mailing Address - Fax:413-586-1543
Practice Address - Street 1:16 CENTER ST
Practice Address - Street 2:SUITE 230
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3031
Practice Address - Country:US
Practice Address - Phone:413-586-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1002931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical