Provider Demographics
NPI:1699973743
Name:URMEY, JACLYN (MSW, LCSW, DCSW)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:
Last Name:URMEY
Suffix:
Gender:F
Credentials:MSW, LCSW, DCSW
Other - Prefix:
Other - First Name:JACLYN
Other - Middle Name:
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW, DCSW
Mailing Address - Street 1:2217 W ARNOLD AVE
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE MDL
Mailing Address - State:NJ
Mailing Address - Zip Code:08641-5201
Mailing Address - Country:US
Mailing Address - Phone:609-754-2542
Mailing Address - Fax:
Practice Address - Street 1:2217 W ARNOLD AVE
Practice Address - Street 2:
Practice Address - City:JOINT BASE MDL
Practice Address - State:NJ
Practice Address - Zip Code:08641-5201
Practice Address - Country:US
Practice Address - Phone:609-754-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053232001041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical