Jennifer A Costello, LCSW
Individual provider Active NPI Clinical Social Worker · Morris Plains, NJ
NPI 1104075746 · NPPES record last updated Sep 18, 2008
Key facts
- NPI
- 1104075746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 44SC05285000 (NJ)
- Practice address
- 329 Malapardis Rd
Morris Plains, NJ 07950-3261 - Phone
- (201) 213-2385
- Fax
- (973) 843-1600
- NPI assigned
- Sep 18, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC05285000 | NJ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jennifer a Costello LCSW LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05285000 | NJ | Yes |
Addresses
Primary practice location
329 Malapardis Rd
Morris Plains, NJ 07950-3261
Mailing address
329 Malapardis Rd
Morris Plains, NJ 07950-3261
Phone (201) 213-2385
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0169536 | Medicaid | NJ |
Other providers in Morris Plains, NJ
- Community Options, Inc.
- Computer Melon Shop, LLC
- Maureen N Connolly
- Dara Ashley Cooper
- Iris Corona
- Crown Wellness Integrated Health
- Daniel Cruz
- CSH Morris Plains Lessee, LLC
- Stephanie D'Amore
- John C. Daily
All providers in Morris Plains, NJ · Clinical Social Worker in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.