Provider Demographics
NPI:1235457854
Name:BAHLER, JENNIFER COOPER (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:COOPER
Last Name:BAHLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S. LIVINGSTON AVENUE
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-727-7924
Mailing Address - Fax:973-535-9293
Practice Address - Street 1:201 S. LIVINGSTON AVENUE
Practice Address - Street 2:SUITE 2F
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-727-7924
Practice Address - Fax:973-535-9293
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00369800101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor