Basic Information
Provider Information
NPI: 1528459609
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RING
FirstName: JESSICA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6550 DELILAH RD STE 301
Address2:  
City: EGG HARBOR TOWNSHIP
State: NJ
PostalCode: 082345102
CountryCode: US
TelephoneNumber: 6092728580
FaxNumber: 6096457343
Practice Location
Address1: 501 SCARBOROUGH DR FL 3
Address2:  
City: EGG HARBOR TOWNSHIP
State: NJ
PostalCode: 082344897
CountryCode: US
TelephoneNumber: 6092728580
FaxNumber: 6096457343
Other Information
ProviderEnumerationDate: 02/11/2015
LastUpdateDate: 04/22/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  N Behavioral Health & Social Service ProvidersCounselor 
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home