Provider Demographics
NPI:1760108864
Name:SCALES, JESSICA (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SCALES
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 1:1120 NJ 73, SUITE 300
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08054
Mailing Address - Country:US
Mailing Address - Phone:904-712-3793
Mailing Address - Fax:
Practice Address - Street 1:1120 NJ 73, SUITE 300
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08054-0805
Practice Address - Country:US
Practice Address - Phone:904-712-3793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056928001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical