Healthcare Provider Details

I. General information

NPI: 1699289157
Provider Name (Legal Business Name): JUSLEINE EXPRESSIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 DENISON STREET
HIGHLAND PARK NJ
08904
US

IV. Provider business mailing address

PO BOX 23
EDISON NJ
08818
US

V. Phone/Fax

Practice location:
  • Phone: 732-610-5119
  • Fax:
Mailing address:
  • Phone: 732-610-5119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05538900
License Number StateNJ

VIII. Authorized Official

Name: MRS. JUSLEINE C DANIEL
Title or Position: CEO
Credential: LCSW, LCADC
Phone: 732-610-5119