Provider Demographics
NPI:1356863344
Name:POSPIS, JEFFREY (LPC, LCADC, CCS)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:POSPIS
Suffix:
Gender:M
Credentials:LPC, LCADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 FOOTHILL DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-1923
Mailing Address - Country:US
Mailing Address - Phone:551-404-1401
Mailing Address - Fax:
Practice Address - Street 1:7 E FREDERICK PL STE 700
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-1816
Practice Address - Country:US
Practice Address - Phone:551-404-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00233100101YA0400X
NJ37AC00336100101YM0800X
NJ37PC00746800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)