Provider Demographics
NPI:1316371339
Name:DELANCEY, JARED P (LCSW)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:P
Last Name:DELANCEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 POLIFLY RD
Mailing Address - Street 2:#307
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3216
Mailing Address - Country:US
Mailing Address - Phone:201-923-2967
Mailing Address - Fax:
Practice Address - Street 1:70 POLIFLY RD
Practice Address - Street 2:#307
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3216
Practice Address - Country:US
Practice Address - Phone:201-923-2967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054930001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical