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NPI Code Detail

MEDICARE: JENNIFER SONG LMSW

MEDICARE: JENNIFER SONG LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker44SL07003300NJ

General Provider Information

NPI Number : 1043166549
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER SONG LMSW
Provider Business Mailing Address
First Line : 530 MAIN ST
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-4506
Country : US
Telephone Number : 201-787-5789
Fax Number :
Provider Business Practice Location Address
First Line : 530 MAIN ST
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-4506
Country : US
Telephone Number : 201-787-5789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2026
Last Update Date : 03/06/2026

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