Healthcare Provider Details

I. General information

NPI: 1407605678
Provider Name (Legal Business Name): JESSICA LYNN PASQUALI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 MAIN ST
SPARTA NJ
07871-1948
US

IV. Provider business mailing address

14 MAIN ST
SPARTA NJ
07871-1948
US

V. Phone/Fax

Practice location:
  • Phone: 201-498-9140
  • Fax:
Mailing address:
  • Phone: 201-498-9140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: