Provider Demographics
NPI:1700208923
Name:CRONIN, JESSICA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:CRONIN
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 1:16 CLUB PL
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-1909
Mailing Address - Country:US
Mailing Address - Phone:732-409-1395
Mailing Address - Fax:
Practice Address - Street 1:16 CLUB PL
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-1909
Practice Address - Country:US
Practice Address - Phone:732-409-1395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05808000104100000X
NJ44SC05644000104100000X
NJ44SC05644001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker