Healthcare Provider Details

I. General information

NPI: 1205816204
Provider Name (Legal Business Name): JILL STEIN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 HIGHWAY 34 SUITE 3
MATAWAN NJ
07747-6680
US

IV. Provider business mailing address

746 HIGHWAY 34 SUITE 3
MATAWAN NJ
07747-6680
US

V. Phone/Fax

Practice location:
  • Phone: 732-264-8878
  • Fax: 732-566-7727
Mailing address:
  • Phone: 732-264-8878
  • Fax: 732-566-7727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44 SC00127500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37 FI00100800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: