Healthcare Provider Details

I. General information

NPI: 1699973743
Provider Name (Legal Business Name): JACLYN FISCHER MSW, LCSW, DCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACLYN FISCHER MSW, LCSW, DCSW

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3458 NEELY RD
MC GUIRE AFB NJ
08641-5312
US

IV. Provider business mailing address

2217 W ARNOLD AVE
JOINT BASE MDL NJ
08641-5201
US

V. Phone/Fax

Practice location:
  • Phone: 866-377-2778
  • Fax: 609-754-9249
Mailing address:
  • Phone: 609-754-2542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05323200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: