Provider Demographics
NPI:1205986262
Name:WOLLE, JANA (LCSW)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:WOLLE
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 1:80 BRIDGE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-1700
Mailing Address - Country:US
Mailing Address - Phone:732-757-9797
Mailing Address - Fax:
Practice Address - Street 1:16 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3506
Practice Address - Country:US
Practice Address - Phone:908-272-2474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053786001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical