Provider Demographics
NPI:1154319382
Name:PREIS, JILL L (LCSW,CADC)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:L
Last Name:PREIS
Suffix:
Gender:F
Credentials:LCSW,CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WEASEL DRIFT RD
Mailing Address - Street 2:
Mailing Address - City:WEST PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2762
Mailing Address - Country:US
Mailing Address - Phone:973-925-8989
Mailing Address - Fax:973-742-0175
Practice Address - Street 1:7 WEASEL DRIFT RD
Practice Address - Street 2:
Practice Address - City:WEST PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07424-2762
Practice Address - Country:US
Practice Address - Phone:973-925-8989
Practice Address - Fax:973-742-0175
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1994R101YA0400X
NJ44SC007638001041C0700X
NJ1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP521810OtherOXFORD INSURANCE CO.