Provider Demographics
NPI:1053282004
Name:DOS SANTOS, JILLIAN (LCSW, CMI-SPANISH)
Entity type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:
Last Name:DOS SANTOS
Suffix:
Gender:F
Credentials:LCSW, CMI-SPANISH
Other - Prefix:MS
Other - First Name:JILLY
Other - Middle Name:
Other - Last Name:DOS SANTOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, CMI-SPANISH
Mailing Address - Street 1:1015 S COMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1209
Mailing Address - Country:US
Mailing Address - Phone:314-252-0101
Mailing Address - Fax:
Practice Address - Street 1:1015 S COMPTON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1209
Practice Address - Country:US
Practice Address - Phone:314-252-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20250381971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical