Provider Demographics
NPI:1326851247
Name:JESPY HOUSE
Entity type:Organization
Organization Name:JESPY HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MANAGER OF CLINIC
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:VISIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-762-6909
Mailing Address - Street 1:76 S ORANGE AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1923
Mailing Address - Country:US
Mailing Address - Phone:973-762-6909
Mailing Address - Fax:
Practice Address - Street 1:76 S ORANGE AVE STE 214
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1923
Practice Address - Country:US
Practice Address - Phone:973-762-6909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JESPY HOUSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty