Provider Demographics
NPI:1851044929
Name:JEAN E HAGER, DSW,LLC
Entity type:Organization
Organization Name:JEAN E HAGER, DSW,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LCSW, LCADC
Authorized Official - Phone:732-747-2055
Mailing Address - Street 1:776 SHREWSBURY AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-4507
Mailing Address - Country:US
Mailing Address - Phone:732-747-2055
Mailing Address - Fax:732-747-6155
Practice Address - Street 1:776 SHREWSBURY AVE STE 204
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-4507
Practice Address - Country:US
Practice Address - Phone:732-747-2055
Practice Address - Fax:732-747-6155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty