Provider Demographics
NPI:1255978177
Name:CALOTTA, JILLIAN (LPC)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:CALOTTA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 E MAIN ST # 216
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-1832
Mailing Address - Country:US
Mailing Address - Phone:973-317-8427
Mailing Address - Fax:
Practice Address - Street 1:10 ADAMS DR
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-2050
Practice Address - Country:US
Practice Address - Phone:973-317-8427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00503300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health