Provider Demographics
NPI:1659193399
Name:BOVE, JESSICA (LSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BOVE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:IMPERATORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6010 BLACK HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-9752
Mailing Address - Country:US
Mailing Address - Phone:609-272-0909
Mailing Address - Fax:609-272-0157
Practice Address - Street 1:6010 BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-9752
Practice Address - Country:US
Practice Address - Phone:609-272-0909
Practice Address - Fax:609-272-0157
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06646000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker