Provider Demographics
NPI:1396028098
Name:BORRELLI, JAIME (LCSW)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:BORRELLI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 RT 9
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721
Mailing Address - Country:US
Mailing Address - Phone:732-349-5550
Mailing Address - Fax:732-349-0841
Practice Address - Street 1:160 RT 9
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721
Practice Address - Country:US
Practice Address - Phone:732-349-5550
Practice Address - Fax:732-349-0841
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054748001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical