Provider Demographics
NPI:1497726087
Name:GREENSPAN, JAMIE (MSW, LCSW, LCADC)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:
Last Name:GREENSPAN
Suffix:
Gender:F
Credentials:MSW, LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 HWY 35
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4077
Mailing Address - Country:US
Mailing Address - Phone:732-272-6672
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 5203 MARYLAND AVENUE
Practice Address - Street 2:ARMY SUBSTANCE ABUSE PROGRAM
Practice Address - City:FORT DIX
Practice Address - State:NJ
Practice Address - Zip Code:08640
Practice Address - Country:US
Practice Address - Phone:609-562-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00076500101YA0400X
NJ44SC052105001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)