Healthcare Provider Details

I. General information

NPI: 1407641939
Provider Name (Legal Business Name): JMD PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 HADDON AVE STE 201
HADDON TOWNSHIP NJ
08108-2800
US

IV. Provider business mailing address

342 HADDON AVE STE 201
HADDON TOWNSHIP NJ
08108-2800
US

V. Phone/Fax

Practice location:
  • Phone: 856-298-1256
  • Fax:
Mailing address:
  • Phone: 856-298-1256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER MARIE DEL RUSSO
Title or Position: OWNER
Credential: PSY.D.
Phone: 856-298-1256