Provider Demographics
NPI:1285998286
Name:GANDHI, JAYSHREE (LPC, LCADC, ACS)
Entity type:Individual
Prefix:MRS
First Name:JAYSHREE
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:LPC, LCADC, ACS
Other - Prefix:MRS
Other - First Name:JAYSHREE
Other - Middle Name:
Other - Last Name:AGRAWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC,LCADC,ACS
Mailing Address - Street 1:4 CLARK ST
Mailing Address - Street 2:SAYREVILLE
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1583
Mailing Address - Country:US
Mailing Address - Phone:201-220-5458
Mailing Address - Fax:
Practice Address - Street 1:30 KNIGHTSBRIDGE RD STE 525
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3963
Practice Address - Country:US
Practice Address - Phone:732-362-4003
Practice Address - Fax:201-812-9569
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00175200101YA0400X
101YP2500X
NJ37PC00461900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional