Provider Demographics
NPI:1013048545
Name:JAIME, CAROLYN F (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:F
Last Name:JAIME
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOLLISTER RD UNIT 7
Mailing Address - Street 2:
Mailing Address - City:TETERBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07608-1139
Mailing Address - Country:US
Mailing Address - Phone:201-498-9140
Mailing Address - Fax:201-498-9140
Practice Address - Street 1:100 HOLLISTER RD UNIT 7
Practice Address - Street 2:
Practice Address - City:TETERBORO
Practice Address - State:NJ
Practice Address - Zip Code:07608-1139
Practice Address - Country:US
Practice Address - Phone:201-498-9140
Practice Address - Fax:201-498-9140
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053505001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ696702Medicare PIN