Jessica Peacock, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05769900 Issued in NJ

Practice address

666 Godwin Ave, Suite 300 and 330
Midland Park, NJ 07432

Phone

(201) 252-7119

NPI assigned

Jun 5, 2018

Sex

Female

Sole proprietor

No

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1346732229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MONHEGAN AVE",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074364018",
            "telephone_number": "201-669-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 GODWIN AVE, SUITE 300 AND 330",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "07432",
            "telephone_number": "201-252-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "JESSICA",
        "name_prefix": "Miss",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05769900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Panissidi, LCSW
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• Patrick Clancy MD, PA
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• Benjamin Daniel Perlman
• Michelle Danielle Peterson, LPC
• Philip M. Schwartz, P.a.

• Clinical Social Worker in Midland Park, NJ
• Providers in Midland Park, 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 Jun 27, 2024; 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.