Provider Demographics
NPI:1134664766
Name:MCCAULEY, JILLIAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:DUNNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:283 7TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-1960
Mailing Address - Country:US
Mailing Address - Phone:917-747-2443
Mailing Address - Fax:
Practice Address - Street 1:283 7TH ST APT 1
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-1960
Practice Address - Country:US
Practice Address - Phone:917-747-2443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01279200235Z00000X
NY024827-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist