Jessica Glass, LPC

Individual provider Active NPI Professional Counselor · River Edge, NJ

NPI 1861949752 · NPPES record last updated Dec 7, 2021

Key facts

NPI
1861949752
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
37PC00555200 (NJ)
Practice address
852 Kinderkamack Rd
River Edge, NJ 07661-2324
Phone
(201) 885-3522
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
37PC00555200NJMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00555200 NJ Yes

Addresses

Primary practice location

852 Kinderkamack Rd
River Edge, NJ 07661-2324

Mailing address

9 Stuart LN
Wayne, NJ 07470-3339
Phone (201) 647-0371

Other providers in River Edge, NJ

All providers in River Edge, NJ · Professional Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.