Provider Demographics
NPI:1508567876
Name:JONES, JENNIFER C (LCADC, LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:JONES
Suffix:
Gender:F
Credentials:LCADC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 LITTLE YORK PATTENBURG RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08848-2059
Mailing Address - Country:US
Mailing Address - Phone:908-399-1558
Mailing Address - Fax:
Practice Address - Street 1:102 LITTLE YORK PATTENBURG RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:08848-2059
Practice Address - Country:US
Practice Address - Phone:908-399-1558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00292300101YA0400X
NJ44SC060254001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)