Provider Demographics
NPI:1427119742
Name:FELCZAK, JACQUELINE (MA, LPC, LCADC)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:
Last Name:FELCZAK
Suffix:
Gender:F
Credentials:MA, LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MILFORD LN
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-1340
Mailing Address - Country:US
Mailing Address - Phone:973-809-1899
Mailing Address - Fax:
Practice Address - Street 1:1618 UNION VALLEY RD
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-2222
Practice Address - Country:US
Practice Address - Phone:973-728-7001
Practice Address - Fax:973-728-7255
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00081200101YA0400X
NJ37PC00287900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional