Provider Demographics
NPI:1740258193
Name:ANDREACH, JASON MICHAEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:MICHAEL
Last Name:ANDREACH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1926
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-1071
Mailing Address - Country:US
Mailing Address - Phone:732-701-0440
Mailing Address - Fax:732-701-0419
Practice Address - Street 1:2424 BRIDGE AVE. SUITE 4
Practice Address - Street 2:ANDREACH & PAULSEN COUNSELING GROUP LLC
Practice Address - City:POINT PLEASANT
Practice Address - State:NJ
Practice Address - Zip Code:08742
Practice Address - Country:US
Practice Address - Phone:732-903-7012
Practice Address - Fax:732-903-7135
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC04571500101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health