JILL COSTELLO (NPI# 1588987465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588987465 |
| Entity Type | Individual |
| Full Name | JILL COSTELLO |
| Credential | MA, LLPC, CAAC |
| Practice Address |
31993 W 12 Mile Rd 311 Farmington Hills MI 48334-3630 |
| Practice Telephone | 2488545158 |
| Mailing Telephone | 2488545158 |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2010-03-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 6401010625 | MI | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
C-00413 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740231802 | Jill C Costello | Internal Medicine | 9200 W Wisconsin Ave, Froedtert & Med College Clin - East, Milwaukee, WI 53226-3522 | 2006-05-13 |
| Street Address |
31993 W 12 MILE RD 311 |
| City | FARMINGTON HILLS |
| State | MI |
| Zip Code | 48334-3630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264535 | Kiah Bradley | Behavior Technician | 2777 Inkster Rd Suite 100, Farmington Hills, MI 48334 | 2020-10-29 |
| 1417557307 | Carsen D Dresbach | Behavior Technician | 2777 Inster Road Suite 100, Farmington Hills, MI 48334 | 2020-10-29 |
| 1316560303 | Amy K Pruneau LLC | Psychologist | 26755 Middlebelt Rd Ste 140, Farmington Hills, MI 48334 | 2020-05-25 |
| 1366089732 | Vian Aljony | Dental Hygienist | 27273 Arden Park Cir, Farmington Hills, MI 48334 | 2019-12-04 |
| 1699311902 | Sandra Zori | Pharmacist | 27800 Middlebelt Rd, Farmington Hills, MI 48334 | 2019-11-21 |
| 1902450471 | Kianna Marie Garcia | Behavior Technician | 27777 Inkster Rd., Farmington Hills, MI 48334 | 2019-08-01 |
| 1619521176 | Samantha Serra | Behavior Technician | 27777 Inkster Rd Suite 100, Farmington Hills, MI 48334 | 2019-08-01 |
| 1851945398 | Kristen Butler | Behavior Technician | 27777 Inkster Road Suite 100, Farmington Hills, MI 48334 | 2019-08-01 |
| 1104489038 | Katherine Kalsow | Behavioral Analyst | 27777 Inkster Rd. Suite 100, Farmington Hills, MI 48334 | 2019-04-16 |
| 1083178487 | Imee Raterta | Physical Therapist | Ability Works Rehab, 28592 Orchard Lake Rd # 300, Farmington Hills, MI 48334 | 2019-01-30 |
| Find all providers in zip 48334 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922573989 | Brian Edmond Spitsbergen | Counselor | 24005 Gill Rd, Farmington Hills, MI 48335-3413 | 2018-10-05 |
| 1164939443 | Xenia Brewington | Counselor | 27777 Inkster Rd, Farmington Hills, MI 48334-5326 | 2018-01-08 |
| 1164933511 | Kaitlyn Wangler | Counselor | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334 | 2017-10-12 |
| 1598294597 | Jaime Taylor Adrian Torres | Counselor | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2017-06-05 |
| 1851830970 | Timothy Granzotto | Counselor | 26105 Orchard Lake Rd, Suite 309, Farmington Hills, MI 48334-4576 | 2017-02-22 |
| 1346798246 | Virginia Dowson | Counselor | 32969 Hamilton Ct, Suite 100, Farmington Hills, MI 48334-3351 | 2016-09-20 |
| 1922486786 | Terry Rebert | Counselor | 28423 Orchard Lake Rd, Ste. 295, Farmington Hills, MI 48334-2971 | 2015-05-13 |
| 1710997432 | Helen H Aguilar | Counselor | 37634 Enterprise Ct, Farmington Hills, MI 48331-3440 | 2006-08-08 |
| 1831135920 | Linda Adel Friedman | Counselor | 33045 Hamilton Ct, Suite W-300, Farmington Hills, MI 48334-3385 | 2006-06-20 |
| 1356388938 | Sidney Harvey Grossberg | Counselor | 33045 Hamilton Ct, Suite W-300, Farmington Hills, MI 48334-3385 | 2006-06-01 |
| Find all providers in FARMINGTON HILLS | ||||
| City | FARMINGTON HILLS |
| Zip Code | 48334 |
Please comment or provide details below to improve the information on JILL COSTELLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.