Healthcare Provider Details

I. General information

NPI: 1558079822
Provider Name (Legal Business Name): JADE ESQUIVEL LCSW, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 10/13/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 EAST ST
MARYDEL DE
19964-2160
US

IV. Provider business mailing address

53 EAST ST
MARYDEL DE
19964-2160
US

V. Phone/Fax

Practice location:
  • Phone: 302-373-2340
  • Fax:
Mailing address:
  • Phone: 302-373-2340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberQ3-0011220
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0012526
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: