Provider Demographics
NPI:1356826184
Name:JENNIFER HOLAK LLC
Entity Type:Organization
Organization Name:JENNIFER HOLAK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLAK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:973-520-7560
Mailing Address - Street 1:130 NEW ROAD
Mailing Address - Street 2:APT N8
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4262
Mailing Address - Country:US
Mailing Address - Phone:973-520-7560
Mailing Address - Fax:
Practice Address - Street 1:913 ROUTE 23
Practice Address - Street 2:STE 6
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1059
Practice Address - Country:US
Practice Address - Phone:973-520-7560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty