Provider Demographics
NPI:1356618029
Name:COZZOLINO, JENNIFER LYNNE (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNNE
Last Name:COZZOLINO
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 1:2517 HIGHWAY 35 STE D201
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1982
Mailing Address - Country:US
Mailing Address - Phone:732-231-5170
Mailing Address - Fax:
Practice Address - Street 1:2517 HIGHWAY 35 STE D201
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1982
Practice Address - Country:US
Practice Address - Phone:732-231-5170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-24
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059378001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical