Provider Demographics
NPI:1679729206
Name:O'BRIEN, JESSICA KNOLL (LCSW, CASAC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:KNOLL
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ANN
Other - Last Name:KNOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12 DALE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:617-312-8872
Mailing Address - Fax:
Practice Address - Street 1:45 RIVER ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901
Practice Address - Country:US
Practice Address - Phone:973-370-0161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079377-11041C0700X
NJ44SC58110001041C0700X
NYCASAC-23901101YA0400X
NY0793771041C0700X
NY23901101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)