Costello, Jennifer A
Costello, Jennifer A is an sole proprietor health care provider with primary practice located at 329 Malapardis Rd , Morris Plains NJ 07950-3261. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Costello, Jennifer A can be contacted via phone (201) 213-2385.Contact Information
Primary practice address
329 Malapardis Rd
Morris Plains NJ 07950-3261
Phone: (201) 213-2385
Fax: (973) 843-1600
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 44SC05285000 | New Jersey |
Profile Details
| NPI number | 1104075746 |
|---|---|
| LBN Legal business name | Costello, Jennifer A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 18th, 2008 |
| Last updated | Sep 18th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104075746 | NPPES |
| New Jersey | MEDICAID | 0169536 |
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