Provider Demographics
NPI:1255597126
Name:GUERRERO, JENNIFER LYN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYN
Last Name:GUERRERO
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 1:68 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1919
Mailing Address - Country:US
Mailing Address - Phone:908-448-2741
Mailing Address - Fax:908-698-0755
Practice Address - Street 1:500 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807
Practice Address - Country:US
Practice Address - Phone:908-725-2800
Practice Address - Fax:908-704-1790
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053454001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023701OtherAGENCY MEDICAID PROVIDER #
NJ527486OtherAGECY MEDICARE PROVIDER #