Provider Demographics
NPI:1811403793
Name:SEARY, JAIVONNE (LMSW)
Entity type:Individual
Prefix:
First Name:JAIVONNE
Middle Name:
Last Name:SEARY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 RIDER CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-3062
Mailing Address - Country:US
Mailing Address - Phone:917-841-5119
Mailing Address - Fax:
Practice Address - Street 1:6 RIDER CT
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-3062
Practice Address - Country:US
Practice Address - Phone:917-841-5119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-14
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091890-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker