Basic Information
Provider Information
NPI: 1033556980
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELPESCE
FirstName: JENNIFER
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 557 JAMES ST
Address2:  
City: MORRISTOWN
State: NJ
PostalCode: 079606321
CountryCode: US
TelephoneNumber: 9739977943
FaxNumber:  
Practice Location
Address1: 151 KNOLLCROFT RD
Address2:  
City: LYONS
State: NJ
PostalCode: 079395001
CountryCode: US
TelephoneNumber: 9086470180
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/03/2013
LastUpdateDate: 06/17/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X  Y Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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