Provider Demographics
NPI:1609551068
Name:SCAVONE, JEFFREY THOMAS (LPC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:THOMAS
Last Name:SCAVONE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 CHARNWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1337
Mailing Address - Country:US
Mailing Address - Phone:908-279-4563
Mailing Address - Fax:
Practice Address - Street 1:800 OLD SPRINGFIELD AVE APT 4
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-1129
Practice Address - Country:US
Practice Address - Phone:908-279-4563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00863800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional