Provider Demographics
NPI:1518323385
Name:JENNIFER L.K. BOILER LLC
Entity Type:Organization
Organization Name:JENNIFER L.K. BOILER LLC
Other - Org Name:ROOTED PSYCHOTHERAPY AND COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEONE KONEN
Authorized Official - Last Name:BOILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-375-2440
Mailing Address - Street 1:782 ROSEVINE LN
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-7064
Mailing Address - Country:US
Mailing Address - Phone:856-375-2440
Mailing Address - Fax:856-424-2949
Practice Address - Street 1:1878 MARLTON PIKE E STE 2
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2090
Practice Address - Country:US
Practice Address - Phone:856-375-2440
Practice Address - Fax:856-424-2949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05607900251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health