Whitehead, Jesse
Whitehead, Jesse is an sole proprietor health care provider with primary practice located at 15 Canterbury Ln , Tinton Falls NJ 07724-2804. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Whitehead, Jesse can be contacted via phone (732) 542-5925.Contact Information
Primary practice address
15 Canterbury Ln
Tinton Falls NJ 07724-2804
Phone: (732) 542-5925
Fax: (732) 542-5841
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 35SI00208700 | New Jersey |
Profile Details
| NPI number | 1225189152 |
|---|---|
| LBN Legal business name | Whitehead, Jesse |
| Credentials | PSY.D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 16th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1225189152 | NPPES |
| New Jersey | MEDICAID | 3475107 |
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