Provider Demographics
NPI:1720861453
Name:AVILA, JOCELYN CHRISTINA (MA, LAC)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:CHRISTINA
Last Name:AVILA
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25B HANOVER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1443
Mailing Address - Country:US
Mailing Address - Phone:973-295-6729
Mailing Address - Fax:
Practice Address - Street 1:25B HANOVER RD STE 100
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1443
Practice Address - Country:US
Practice Address - Phone:973-295-6729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00731300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health