Provider Demographics
NPI:1407910813
Name:ECKERT, JENNIFER SHARON (LCSW, LCADC, CPS)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SHARON
Last Name:ECKERT
Suffix:
Gender:F
Credentials:LCSW, LCADC, CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 ATLANTIC AVE
Mailing Address - Street 2:RM 171
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1029
Mailing Address - Country:US
Mailing Address - Phone:732-223-6565
Mailing Address - Fax:732-223-6565
Practice Address - Street 1:1913 ATLANTIC AVE
Practice Address - Street 2:RM 171
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1029
Practice Address - Country:US
Practice Address - Phone:732-223-6565
Practice Address - Fax:732-223-6565
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00045000101YA0400X
NJ44SC051603001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)