Provider Demographics
NPI:1316236003
Name:HOUGHTON, JESSICA (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HOUGHTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 S WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1659
Mailing Address - Country:US
Mailing Address - Phone:856-617-4542
Mailing Address - Fax:
Practice Address - Street 1:739 S WHITE HORSE PIKE
Practice Address - Street 2:SUITE 10
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1659
Practice Address - Country:US
Practice Address - Phone:856-617-4542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055012001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical