Provider Demographics
NPI:1174172852
Name:SCOTT-ENERSON, JILL (MS, MFT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:SCOTT-ENERSON
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SUFFOLK RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1223
Mailing Address - Country:US
Mailing Address - Phone:860-304-9346
Mailing Address - Fax:
Practice Address - Street 1:18 SUFFOLK RD
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1223
Practice Address - Country:US
Practice Address - Phone:860-304-9346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor