Provider Demographics
NPI:1760127005
Name:FUHR, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FUHR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1723
Mailing Address - Country:US
Mailing Address - Phone:201-906-4755
Mailing Address - Fax:
Practice Address - Street 1:THRIVE AT MONTVALE
Practice Address - Street 2:110 SUMMIT AVENUE
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645
Practice Address - Country:US
Practice Address - Phone:201-201-8815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC04530700101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor