MEDICARE: JENNIFER KOELLN LSW

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
1	104100000X	Social Worker	44SL06472700	NJ

General Provider Information

NPI Number	:	1265095517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER KOELLN LSW

Provider Business Mailing Address
First Line	:	121 GENEVIEVE AVE
Second Line	:
City	:	HAWTHORNE
State	:	NJ
Zip	:	07506-2321
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 STATE RT 46 W STE 100
Second Line	:
City	:	HASBROUCK HEIGHTS
State	:	NJ
Zip	:	07604-3120
Country	:	US
Telephone Number	:	201-478-4166
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2019
Last Update Date	:	04/22/2019

Similar Medicare Providers

1043980618 — NATHALIE AUGUSTIN LAC
Practice Location Address:

611 US HIGHWAY 46 W STE 100
HASBROUCK HEIGHTS, NJ
07604-3120

Practice Phone: 201-478-4183
Practice Fax: 201-478-4185

1538645429 — JAMIE L CAMERON
Practice Location Address:

611 US HIGHWAY 46 W STE 100
HASBROUCK HEIGHTS, NJ
07604-3120

Practice Phone: 201-478-4162
Practice Fax:

1124590344 — GABRIELLE CHRISTINE CENTRA-TAYLOR BCBA
Practice Location Address:

611 US HIGHWAY 46 W STE 302
HASBROUCK HEIGHTS, NJ
07604-3120

Practice Phone: 201-870-4467
Practice Fax:

1174096366 — PAMELA KULISEK
Practice Location Address:

611 US HIGHWAY 46 W
HASBROUCK HEIGHTS, NJ
07604-3120

Practice Phone: 201-478-4162
Practice Fax:

1992318471 — GABRIELLA ANTONIELLO LSW
Practice Location Address:

611 US HIGHWAY 46 W
HASBROUCK HEIGHTS, NJ
07604-3120

Practice Phone: 201-478-4162
Practice Fax:

1023777893 — MARISSA CHIZMADIA BCBA
Practice Location Address:

611 US HIGHWAY 46 W STE 302
HASBROUCK HEIGHTS, NJ
07604-3120

Practice Phone: 201-720-8600
Practice Fax:

Directions to “ JENNIFER KOELLN LSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.