Provider Demographics
NPI:1891239752
Name:STEGLIC, JAMIE (LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:STEGLIC
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 STANHOPE RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2700
Mailing Address - Country:US
Mailing Address - Phone:973-775-2854
Mailing Address - Fax:
Practice Address - Street 1:408 MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-1768
Practice Address - Country:US
Practice Address - Phone:973-775-2854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00545600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional