Provider Demographics
NPI:1811225790
Name:BRONSNICK, JENNIFER (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BRONSNICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:21 MOUNT PLEASANT PKWY
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2820
Mailing Address - Country:US
Mailing Address - Phone:646-522-2123
Mailing Address - Fax:
Practice Address - Street 1:46 ESSEX ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1607
Practice Address - Country:US
Practice Address - Phone:866-488-4552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053548001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical