Provider Demographics
NPI:1962165001
Name:ATILES, JENNIFER LYNN (MA, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:ATILES
Suffix:
Gender:
Credentials:MA, LPC, NCC
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LAC, NCC
Mailing Address - Street 1:9 GROVEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08620-9672
Mailing Address - Country:US
Mailing Address - Phone:609-954-3717
Mailing Address - Fax:
Practice Address - Street 1:9 GROVEVILLE RD
Practice Address - Street 2:
Practice Address - City:BORDENTOWN TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08620-9672
Practice Address - Country:US
Practice Address - Phone:609-954-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01140400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional