Provider Demographics
NPI:1487396214
Name:DENIZ, JACQUELINE M (MSW, LSW)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:M
Last Name:DENIZ
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 CRESSON AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-4315
Mailing Address - Country:US
Mailing Address - Phone:609-335-4733
Mailing Address - Fax:
Practice Address - Street 1:801 CRESSON AVE
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-4315
Practice Address - Country:US
Practice Address - Phone:609-335-4733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL062910001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical