Provider Demographics
NPI:1417387515
Name:MELE, JENNIFER MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICHELLE
Last Name:MELE
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 1:180 FRANKLIN CORNER RD
Mailing Address - Street 2:APT J17
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2525
Mailing Address - Country:US
Mailing Address - Phone:609-651-0653
Mailing Address - Fax:
Practice Address - Street 1:180 FRANKLIN CORNER RD
Practice Address - Street 2:APT J17
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2525
Practice Address - Country:US
Practice Address - Phone:609-651-0653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC055537001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical