Provider Demographics
NPI:1871010397
Name:DAIGLE, JOCELYN LEA (BC-DMT, LPC, LCPC)
Entity Type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:LEA
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:BC-DMT, LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 CHAPEL AVE W
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2048
Mailing Address - Country:US
Mailing Address - Phone:856-488-6701
Mailing Address - Fax:
Practice Address - Street 1:2201 CHAPEL AVENUE W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002
Practice Address - Country:US
Practice Address - Phone:856-488-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4313101YP2500X
PAPC007516101YP2500X
BC-DMT-1130225600000X
NJ37PC00578200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist