Provider Demographics
NPI:1881203396
Name:CASCALHEIRA, JESSICA M (PSYD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:CASCALHEIRA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SPARTA AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1120
Mailing Address - Country:US
Mailing Address - Phone:973-726-4533
Mailing Address - Fax:973-726-0617
Practice Address - Street 1:350 SPARTA AVE
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1120
Practice Address - Country:US
Practice Address - Phone:973-726-4533
Practice Address - Fax:973-726-0617
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty