Provider Demographics
NPI:1780112482
Name:KESSLER, JILLIAN BENINCASA (LPC LCADC)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:BENINCASA
Last Name:KESSLER
Suffix:
Gender:F
Credentials:LPC LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 STATE ROUTE 138 STE 3A
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9021
Mailing Address - Country:US
Mailing Address - Phone:732-890-0276
Mailing Address - Fax:
Practice Address - Street 1:3100 STATE ROUTE 138 STE 3A
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-9021
Practice Address - Country:US
Practice Address - Phone:732-890-0276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00719400101YM0800X
NJ37LC00234200101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health