Healthcare Provider Details

I. General information

NPI: 1225684772
Provider Name (Legal Business Name): JENNIFER CELLA-ROE, LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 E. JIMMIE LEEDS RD STE 7 #270
GALLOWAY NJ
08205-4126
US

IV. Provider business mailing address

325 E. JIMMIE LEEDS RD STE 7 #270
GALLOWAY NJ
08205-4126
US

V. Phone/Fax

Practice location:
  • Phone: 609-703-8270
  • Fax: 609-646-3235
Mailing address:
  • Phone: 609-703-8270
  • Fax: 609-646-3235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JENNIFER CELLA ROE
Title or Position: OWNER
Credential: LCSW
Phone: 609-703-4455