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General NPI Number Information
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NPI Number | 1063985893
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Entity Type | Individual
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Provider Name | JESSICA GERSTEIN
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Gender | Female
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 727 N BEERS ST
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City | HOLMDEL
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State | NJ
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Zip | 07733-1514
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Country | US
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Telephone | 732-497-1776
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Fax |
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Provider Business Mailing Address
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Address Line | 1 RIVERVIEW PLZ
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City | RED BANK
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State | NJ
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Zip | 07701-1864
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC00701700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00309400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6377
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH23335
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC012729
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 12878
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License Number State | OK
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