Provider Demographics
NPI:1689031510
Name:ANGLEY, JESSICA (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ANGLEY
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 1:116 VILLAGE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5700
Mailing Address - Country:US
Mailing Address - Phone:732-723-8028
Mailing Address - Fax:732-753-0088
Practice Address - Street 1:116 VILLAGE BLVD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5700
Practice Address - Country:US
Practice Address - Phone:732-723-8028
Practice Address - Fax:732-753-0088
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00541600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional