Provider Demographics
NPI:1225194335
Name:CALLI, JEFFREY JOHN (LPC, LCADC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:JOHN
Last Name:CALLI
Suffix:
Gender:M
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1162 LAKE DR E
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-4105
Mailing Address - Country:US
Mailing Address - Phone:609-259-2342
Mailing Address - Fax:
Practice Address - Street 1:13 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-1401
Practice Address - Country:US
Practice Address - Phone:609-259-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC 195101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ30-0334192Medicare UPIN