Provider Demographics
NPI:1497411656
Name:YAWGER, JENIFER L (LCSW)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:L
Last Name:YAWGER
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 1:86 OMAHA AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-1514
Mailing Address - Country:US
Mailing Address - Phone:908-295-6751
Mailing Address - Fax:
Practice Address - Street 1:86 OMAHA AVE
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-1514
Practice Address - Country:US
Practice Address - Phone:908-295-6751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055335001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical