Provider Demographics
NPI:1366082034
Name:BECKER, JILL ANN (MA)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ANN
Last Name:BECKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:ANN
Other - Last Name:MEDEIROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 QUAKER LN STE 302
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-7625
Mailing Address - Country:US
Mailing Address - Phone:401-409-8886
Mailing Address - Fax:
Practice Address - Street 1:207 QUAKER LN STE 302
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-7625
Practice Address - Country:US
Practice Address - Phone:401-409-8886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor