Provider Demographics
NPI:1649160896
Name:GORALEWSKI, JILLIAN MILA
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:MILA
Last Name:GORALEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MERCER ST APT 11A
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1519
Mailing Address - Country:US
Mailing Address - Phone:845-249-8675
Mailing Address - Fax:
Practice Address - Street 1:150 MERCER ST APT 11A
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1519
Practice Address - Country:US
Practice Address - Phone:845-249-8675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor