Healthcare Provider Details

I. General information

NPI: 1467318014
Provider Name (Legal Business Name): JENNIFER DISILVESTRO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER ORJELICK

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 SEAGRAPE DR APT 103
JUPITER FL
33458-7893
US

IV. Provider business mailing address

145 SEAGRAPE DR APT 103
JUPITER FL
33458-7893
US

V. Phone/Fax

Practice location:
  • Phone: 561-930-2065
  • Fax:
Mailing address:
  • Phone: 561-930-2065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23514
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: