Provider Demographics
NPI:1386039030
Name:LEVINE, JARED (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:
Last Name:LEVINE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:JARED
Other - Middle Name:
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:16 BAYBERRY WAY
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3195
Mailing Address - Country:US
Mailing Address - Phone:732-216-3959
Mailing Address - Fax:
Practice Address - Street 1:16 BAYBERRY WAY
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-3195
Practice Address - Country:US
Practice Address - Phone:732-216-3959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055932001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical