Jennifer D Derisse, LCADC
Counselor, Addiction (Substance Use Disorder) in Kearny, New Jersey
1336784826- Practice location
- 206 Bergen Ave, Kearny, NJ 07032-3384
- Phone
- 732-210-0509
- Fax
- —
- Last updated
- November 8, 2019
Jennifer D Derisse is a Counselor, Addiction (Substance Use Disorder) based in Kearny, NJ. Jennifer D Derisse practices in Kearny, NJ and has the professional credentials of LCADC. The NPI Number for Jennifer D Derisse is 1336784826 and holds a License No. 37LC00296100. The current practice location address for Jennifer D Derisse is 206 Bergen Ave, Kearny, NJ 07032-3384 and can be reached out via phone at 732-210-0509.
Provider Profile Details
- NPI Number
- 1336784826
- Provider Name
- Jennifer D Derisse
- Credential
- LCADC
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 206 Bergen Ave, Kearny, NJ 07032-3384
- Phone Number
- 732-210-0509
- Primary Taxonomy
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X
- Sole Proprietor
- No
- Provider Enumeration Date
- November 8, 2019
- Last Update Date
- November 8, 2019
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 206 Bergen Ave
Kearny, NJ 07032-3384 - City
- Kearny
- State
- New Jersey
- Zip
- 07032-3384
- Phone Number
- 732-210-0509
Provider Business Mailing Address Details
- Address
- 206 Bergen Ave
Kearny, NJ 07032-3384 - City
- Kearny
- State
- NJ
- Zip
- 07032-3384
- Phone Number
- 732-210-0509
License Information
- License Number
- 37LC00296100
- Taxonomy
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jennifer D Derisse, LCADC?
The NPI number of Jennifer D Derisse, LCADC is 1336784826. It was assigned on November 8, 2019 and is currently active in the NPPES registry.
What is the specialty of Jennifer D Derisse, LCADC?
Jennifer D Derisse, LCADC is registered under the primary taxonomy Counselor, Addiction (Substance Use Disorder) (code 101YA0400X), licensed under license number 37LC00296100.
Where does Jennifer D Derisse, LCADC practice?
The practice location is 206 Bergen Ave, Kearny, NJ 07032-3384. The office can be reached at 732-210-0509 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1336784826 directly on the NPPES registry website.