Provider Demographics
NPI:1043712573
Name:BASILE, JAIME LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:LEE
Last Name:BASILE
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 1:1691 ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1245
Mailing Address - Country:US
Mailing Address - Phone:732-914-3848
Mailing Address - Fax:
Practice Address - Street 1:1691 ROUTE 9
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1245
Practice Address - Country:US
Practice Address - Phone:732-914-3848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057690001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical