Provider Demographics
NPI:1972934792
Name:JESSIE, SHARON LYNN (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LYNN
Last Name:JESSIE
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 1:178 SUSAN DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1143
Mailing Address - Country:US
Mailing Address - Phone:732-604-8419
Mailing Address - Fax:
Practice Address - Street 1:538 FRANK APPLEGATE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-4221
Practice Address - Country:US
Practice Address - Phone:732-604-8419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44C06377200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker