Provider Demographics
NPI:1639723018
Name:GARCIA, JENNIFER S (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNNE
Other - Last Name:SELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW, MSW
Mailing Address - Street 1:609 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08093-2217
Mailing Address - Country:US
Mailing Address - Phone:410-727-1046
Mailing Address - Fax:
Practice Address - Street 1:609 WINDING WAY
Practice Address - Street 2:
Practice Address - City:WESTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08093-2217
Practice Address - Country:US
Practice Address - Phone:410-727-1046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06236000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker