Provider Demographics
NPI:1245311018
Name:RISPOLI, JENNI S (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JENNI
Middle Name:S
Last Name:RISPOLI
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 1:233 HICKORY CORNER RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1218
Mailing Address - Country:US
Mailing Address - Phone:516-381-3218
Mailing Address - Fax:
Practice Address - Street 1:233 HICKORY CORNER RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1218
Practice Address - Country:US
Practice Address - Phone:516-381-3218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069957-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health