Provider Demographics
NPI:1700109592
Name:KLOTZKIN, JENNIFER LORI (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LORI
Last Name:KLOTZKIN
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 1:22 SPRINGBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1625
Mailing Address - Country:US
Mailing Address - Phone:973-379-4242
Mailing Address - Fax:
Practice Address - Street 1:655 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-1325
Practice Address - Country:US
Practice Address - Phone:908-352-8375
Practice Address - Fax:908-352-8858
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05408700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker