Provider Demographics
NPI:1518689926
Name:MAHER, JENNIFER (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MAHER
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 1:424 STAGECOACH ROAD
Mailing Address - Street 2:PO BOX 422
Mailing Address - City:CLARKSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-2214
Mailing Address - Country:US
Mailing Address - Phone:732-851-3452
Mailing Address - Fax:
Practice Address - Street 1:25 N COUNTY LINE RD STE 19
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1270
Practice Address - Country:US
Practice Address - Phone:732-851-3452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014517101Y00000X
NJ37AC00583900101Y00000X
VA0701012633101YM0800X
NJ37PC00929800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor