Provider Demographics
NPI:1922303841
Name:O'GARA -MANKOWSKI, JESSICA (BA/MSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:O'GARA -MANKOWSKI
Suffix:
Gender:F
Credentials:BA/MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CURTIS CT
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1532
Mailing Address - Country:US
Mailing Address - Phone:908-476-2865
Mailing Address - Fax:
Practice Address - Street 1:1802 BOULEVARD
Practice Address - Street 2:
Practice Address - City:SEASIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:08752-1209
Practice Address - Country:US
Practice Address - Phone:908-476-2865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053498001041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical