Provider Demographics
NPI:1447472311
Name:HAZELL, JILL K (MSW)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:K
Last Name:HAZELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E. 6TH ST.
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152
Mailing Address - Country:US
Mailing Address - Phone:816-587-4100
Mailing Address - Fax:816-587-6691
Practice Address - Street 1:7400 NW RIVER PARK DR
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-5028
Practice Address - Country:US
Practice Address - Phone:816-777-0356
Practice Address - Fax:816-777-0360
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080373611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical