Active NPI
Jackie Soul Catering LLC
- Forensic Psychologist
- Irvington, NJ
National Provider Identifier
1124935200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- Legal business name
- JACKIE SOUL CATERING LLC
- Practice address
- 14 Walter PL
Irvington, NJ 07111-2692 - Phone
- (201) 247-0234
- NPI assigned
- Aug 25, 2026
- Last updated
- Aug 25, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Harquan Maurice Williams Jr.
- Title
- Owner
- Phone
- (201) 247-0234
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | Primary |
Addresses
Primary practice location
14 Walter PL
Irvington, NJ 07111-2692
Mailing address
14 Walter PL
Irvington, NJ 07111-2692
Phone (201) 247-0234
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787616000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787616000000",
"number": "1124935200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 WALTER PL",
"city": "IRVINGTON",
"state": "NJ",
"postal_code": "071112692",
"telephone_number": "201-247-0234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 WALTER PL",
"city": "IRVINGTON",
"state": "NJ",
"postal_code": "071112692",
"telephone_number": "201-247-0234"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACKIE SOUL CATERING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-08-25",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "HARQUAN",
"authorized_official_middle_name": "MAURICE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "201-247-0234",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Forensic",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Irvington, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.