Healthcare Provider Details

I. General information

NPI: 1174388177
Provider Name (Legal Business Name): JILLIAN L LEHMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

398 CONCETTA DR
MOUNT ROYAL NJ
08061-1112
US

IV. Provider business mailing address

398 CONCETTA DR
MOUNT ROYAL NJ
08061-1112
US

V. Phone/Fax

Practice location:
  • Phone: 856-383-5230
  • Fax:
Mailing address:
  • Phone: 856-383-5230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06308400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: