Healthcare Provider Details

I. General information

NPI: 1174370423
Provider Name (Legal Business Name): JENNIFER K GERMAN LMHC-D, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 S ORANGE AVE
NEWARK NJ
07103-2757
US

IV. Provider business mailing address

183 S ORANGE AVE
NEWARK NJ
07103-2757
US

V. Phone/Fax

Practice location:
  • Phone: 862-358-4560
  • Fax:
Mailing address:
  • Phone: 862-358-4560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number01459901
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01125300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: