Provider Demographics
NPI:1013535905
Name:CREHAN, JODI ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:ANN
Last Name:CREHAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1429
Mailing Address - Country:US
Mailing Address - Phone:908-216-1582
Mailing Address - Fax:
Practice Address - Street 1:32 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1100
Practice Address - Country:US
Practice Address - Phone:908-448-9282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05837200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health