Provider Demographics
NPI:1891408621
Name:JENNIFER DIMARCO
Entity Type:Organization
Organization Name:JENNIFER DIMARCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:732-947-2099
Mailing Address - Street 1:1807 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-2234
Mailing Address - Country:US
Mailing Address - Phone:732-947-2099
Mailing Address - Fax:
Practice Address - Street 1:1807 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-2234
Practice Address - Country:US
Practice Address - Phone:732-947-2099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health