Provider Demographics
NPI:1700280237
Name:GIAMBRA, JESSICA (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:GIAMBRA
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 1:500 ORCHARD AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1812
Mailing Address - Country:US
Mailing Address - Phone:201-491-4896
Mailing Address - Fax:484-731-9069
Practice Address - Street 1:500 ORCHARD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1812
Practice Address - Country:US
Practice Address - Phone:201-491-4896
Practice Address - Fax:484-731-9069
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9403101YA0400X
DE1540101YA0400X
PASW130638104100000X
NJ44SL05857700104100000X
PACW0195591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker