Jeanne Marie Koller, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC00852500 Issued in NJ

Practice address

90 W Main St
2ND Floor
Freehold, NJ 07728-2144

Phone

(732) 577-0740

Fax

(732) 577-1639

NPI assigned

Sep 5, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1093909863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077390412",
            "telephone_number": "732-895-7227",
            "fax_number": "732-577-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 W MAIN ST",
            "address_2": "2ND FLOOR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282144",
            "telephone_number": "732-577-0740",
            "fax_number": "732-577-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00852500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S Kirwin, MD
• Jean Klein Taylor, P.T.
• Alyssa Kleinman
• Gabrielle Klimowicz
• William Kohlberg, M.D.
• Ana Kolodko, CNM
• Vivian Akrive Kominos, M.D.
• David Y Kong, O.D.
• Jerry Kong, P.A.
• Dana Stacey Konig, LCSW

• Clinical Social Worker in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.