Provider Demographics
NPI:1851612345
Name:GRIESS, JANE M (MSW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:GRIESS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 HADDONFIELD BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3714
Mailing Address - Country:US
Mailing Address - Phone:856-857-6920
Mailing Address - Fax:856-429-3826
Practice Address - Street 1:707 HADDONFIELD BERLIN RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3714
Practice Address - Country:US
Practice Address - Phone:856-857-6920
Practice Address - Fax:856-429-3826
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05441600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker