Healthcare Provider Details

I. General information

NPI: 1427249853
Provider Name (Legal Business Name): JEROME CARROLL LEARY LMFT MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 SYCAMORE AVENUE
LITTLE SILVER NJ
07739
US

IV. Provider business mailing address

44 SYCAMORE AVENUE BLG 3
LITTLE SILVER NJ
07739
US

V. Phone/Fax

Practice location:
  • Phone: 732-933-1375
  • Fax:
Mailing address:
  • Phone: 732-933-1375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37F100055300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: