Provider Demographics
NPI:1588256770
Name:OCALLAGHAN, JACLYN S (LCSW)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:S
Last Name:OCALLAGHAN
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 1:213 ADDISON PL
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4524
Mailing Address - Country:US
Mailing Address - Phone:201-394-4330
Mailing Address - Fax:
Practice Address - Street 1:65 NORTH MAPLE AVENUE
Practice Address - Street 2:C/O MARJORIE LAGSTEIN SUITE 220
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450
Practice Address - Country:US
Practice Address - Phone:201-394-4330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052591001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical