Provider Demographics
NPI:1518652908
Name:URENA, JAZMARIE
Entity Type:Individual
Prefix:MRS
First Name:JAZMARIE
Middle Name:
Last Name:URENA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JAZMARIE
Other - Middle Name:
Other - Last Name:RIVERA-URENA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LCADC
Mailing Address - Street 1:35 MELVIN AVE
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2439
Mailing Address - Country:US
Mailing Address - Phone:908-906-5981
Mailing Address - Fax:
Practice Address - Street 1:373 CLERMONT TER
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-8073
Practice Address - Country:US
Practice Address - Phone:908-355-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00363100101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)