Jackie Adams
Individual provider Active NPI Mental Health Counselor · Fair Lawn, NJ
NPI 1851064273 · NPPES record last updated Jul 30, 2021
Key facts
- NPI
- 1851064273
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 22-08 Route 208
Fair Lawn, NJ 07410-2609 - Phone
- (201) 740-7085
- NPI assigned
- Jul 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
22-08 Route 208
Fair Lawn, NJ 07410-2609
Mailing address
22-08 Route 208
Fair Lawn, NJ 07410-2609
Phone (201) 740-7085
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All providers in Fair Lawn, NJ · Mental Health Counselor 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 Jul 30, 2021. 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.