Provider Demographics
NPI:1346239621
Name:SULESKI, JASON B (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:B
Last Name:SULESKI
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SYCAMORE CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-4071
Mailing Address - Country:US
Mailing Address - Phone:732-718-4971
Mailing Address - Fax:732-605-1672
Practice Address - Street 1:710 TENNENT RD
Practice Address - Street 2:SUITE 303
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3161
Practice Address - Country:US
Practice Address - Phone:732-718-4971
Practice Address - Fax:732-605-1672
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC049375001041C0700X
NJ1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool