Provider Demographics
NPI:1740587955
Name:KERR, JENNIFER REBECCA (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:REBECCA
Last Name:KERR
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 1:193 GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2952
Mailing Address - Country:US
Mailing Address - Phone:908-616-0385
Mailing Address - Fax:
Practice Address - Street 1:133 FLEMING ST
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3350
Practice Address - Country:US
Practice Address - Phone:732-264-8878
Practice Address - Fax:732-752-2977
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053201001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical