Provider Demographics
NPI:1922357730
Name:MAGUIRE, JENNIFER ROSE (MS, MA, LPC, ACS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROSE
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:MS, MA, LPC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2081
Mailing Address - Country:US
Mailing Address - Phone:609-365-2601
Mailing Address - Fax:609-365-2519
Practice Address - Street 1:421 BETHEL RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2081
Practice Address - Country:US
Practice Address - Phone:609-365-2601
Practice Address - Fax:609-365-2519
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00446300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health