Provider Demographics
NPI:1780879452
Name:GAGLIARDI, JEANNETTE MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:MARIE
Last Name:GAGLIARDI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:JEANNETTE
Other - Middle Name:MARIE
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:123 EGG HARBOR RD STE 202
Mailing Address - Street 2:TOWER COMMONS OFFICE COMPLEX, BUILDING 200
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9406
Mailing Address - Country:US
Mailing Address - Phone:856-347-0445
Mailing Address - Fax:856-228-1096
Practice Address - Street 1:123 EGG HARBOR RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9406
Practice Address - Country:US
Practice Address - Phone:856-347-0445
Practice Address - Fax:856-228-1096
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053321001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical