Provider Demographics
NPI:1821310046
Name:SCHOEFFER-REYNOLDS, JAIMIE LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JAIMIE
Middle Name:LYNN
Last Name:SCHOEFFER-REYNOLDS
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 1:589 FRANKLIN TPKE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1989
Mailing Address - Country:US
Mailing Address - Phone:347-886-4541
Mailing Address - Fax:201-836-0249
Practice Address - Street 1:589 FRANKLIN TPKE
Practice Address - Street 2:SUITE 7
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1989
Practice Address - Country:US
Practice Address - Phone:347-886-4541
Practice Address - Fax:201-836-0249
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052708001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092476Medicare UPIN