Healthcare Provider Details

I. General information

NPI: 1386227528
Provider Name (Legal Business Name): JENNIFER L. CERTA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 STONEY CREEK LN
COLTS NECK NJ
07722-1657
US

IV. Provider business mailing address

98 OAK TREE LN
TOMS RIVER NJ
08753-2522
US

V. Phone/Fax

Practice location:
  • Phone: 732-943-6791
  • Fax:
Mailing address:
  • Phone: 609-618-3997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06634800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: