Healthcare Provider Details

I. General information

NPI: 1013870674
Provider Name (Legal Business Name): JILL CARPENTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 RIVER ST STE 9
HOBOKEN NJ
07030-5990
US

IV. Provider business mailing address

93 MEADOWBROOK RD
BRICK NJ
08723-7867
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax: 929-596-7897
Mailing address:
  • Phone: 732-688-4908
  • Fax: 732-920-5960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06490400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: