Provider Demographics
NPI:1548427495
Name:GIACALONE BUTTERFIELD, JAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JAY
Middle Name:
Last Name:GIACALONE BUTTERFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 SPEAR ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2147
Mailing Address - Country:US
Mailing Address - Phone:732-452-0397
Mailing Address - Fax:
Practice Address - Street 1:402 MAIN ST
Practice Address - Street 2:SUITE 206
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1846
Practice Address - Country:US
Practice Address - Phone:732-452-0397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046008001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ585488Medicare UPIN