Provider Demographics
NPI:1972724425
Name:JAMSEK, MICHELLE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:JAMSEK
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 2ND ST # 2
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3408
Mailing Address - Country:US
Mailing Address - Phone:201-240-6161
Mailing Address - Fax:
Practice Address - Street 1:776 2ND ST # 2
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3408
Practice Address - Country:US
Practice Address - Phone:201-240-6161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052646001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3658845OtherOXFORD HEALTH INSURANCE
NJ78028416996440OtherBLUE CROSS BLUE SHIELD
NJ841699644OtherAETNA