Healthcare Provider Details

I. General information

NPI: 1962184457
Provider Name (Legal Business Name): JENNIFER JOY LAPPIN MA, LCADC INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 STEPHENSON AVE UNIT C
OCEANPORT NJ
07757-1242
US

IV. Provider business mailing address

1075 STEPHENSON AVE UNIT C
OCEANPORT NJ
07757-1242
US

V. Phone/Fax

Practice location:
  • Phone: 848-208-2636
  • Fax: 848-208-2051
Mailing address:
  • Phone: 848-208-2636
  • Fax: 848-208-2051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: