Fuller, Jerry Lee

Fuller, Jerry Lee is an individual health care provider with primary practice located at 31 North Ave , Bloomfield NJ 07003-5516. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fuller, Jerry Lee can be contacted via phone (973) 338-8530.

Contact Information

Primary practice address
31 North Ave Bloomfield NJ 07003-5516
Phone: (973) 338-8530
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 44SC05222700 New Jersey

Profile Details

NPI number 1801953716
LBN Legal business name Fuller, Jerry Lee
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Feb 2nd, 2009 - 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.

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