Healthcare Provider Details
I. General information
NPI: 1801916465
Provider Name (Legal Business Name): JACYNTH M PELLAND LCSW,ACSW,LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8 MAIN ST
FLEMINGTON NJ
08822-1468
US
IV. Provider business mailing address
322 SUMMIT PL
HIGHLAND PARK NJ
08904-2508
US
V. Phone/Fax
- Phone: 908-788-1900
- Fax:
- Phone: 732-249-1905
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 37LC00064900 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 44SC0440000900 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: