Healthcare Provider Details

I. General information

NPI: 1346239621
Provider Name (Legal Business Name): JASON B. SULESKI MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 TENNENT RD SUITE 303
MANALAPAN NJ
07726-3161
US

IV. Provider business mailing address

7 SYCAMORE CT
MONROE NJ
08831-4071
US

V. Phone/Fax

Practice location:
  • Phone: 732-718-4971
  • Fax: 732-605-1672
Mailing address:
  • Phone: 732-718-4971
  • Fax: 732-605-1672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04937500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: