Provider Demographics
NPI:1962182758
Name:WARREN, JACQUELINE (LPC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 MARSHALL CORNER WOODSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-2819
Mailing Address - Country:US
Mailing Address - Phone:908-229-0750
Mailing Address - Fax:
Practice Address - Street 1:126 MARSHALL CORNER WOODSVILLE RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-2819
Practice Address - Country:US
Practice Address - Phone:908-229-0750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00880400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional