Provider Demographics
NPI:1093902926
Name:ESTREICHER, JESSICA LYNNE (LSW)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LYNNE
Last Name:ESTREICHER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2267
Mailing Address - Country:US
Mailing Address - Phone:917-282-7733
Mailing Address - Fax:
Practice Address - Street 1:80 OAKVIEW AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2202
Practice Address - Country:US
Practice Address - Phone:917-282-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052888001041C0700X
NJ44SL06878600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical