Provider Demographics
NPI:1942688106
Name:UNGER, JENNIFER A (LCSW, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:UNGER
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:KILDEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:5 REGENT STREET, SUITE 518
Mailing Address - Street 2:GENPSYCH
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-994-1011
Mailing Address - Fax:973-994-1220
Practice Address - Street 1:395 SOUTH CENTER STREET
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050
Practice Address - Country:US
Practice Address - Phone:973-675-3817
Practice Address - Fax:973-673-5782
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056592001041C0700X
NJ37LC00239700101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ216352Medicare Oscar/Certification