Provider Demographics
NPI:1508166240
Name:GARVEY, JODIE LYNNE (LPC)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:LYNNE
Last Name:GARVEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ALPHA
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-4507
Mailing Address - Country:US
Mailing Address - Phone:908-930-8988
Mailing Address - Fax:
Practice Address - Street 1:6 DUMONT PL
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-8104
Practice Address - Country:US
Practice Address - Phone:908-930-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023701OtherAGENCY MEDICAID PROVIDER #
NJ527486OtherAGENCY MEDICARE PROVIDER #
NJ7794703OtherAGENCY PROGRAM PROVIDER MEDCAID #