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General NPI Number Information
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NPI Number | 1104248673
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Entity Type | Individual
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Provider Name | JENNIFER BASILONE LPC
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Gender | Female
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 623 LAFAYETTE AVE STE 201F
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City | HAWTHORNE
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State | NJ
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Zip | 07506-2439
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Country | US
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Telephone | 201-690-1764
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Fax | 973-891-0763
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Provider Business Mailing Address
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Address Line | 623 LAFAYETTE AVE STE 201-F
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City | HAWTHORNE
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State | NJ
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Zip | 07506-2439
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Country | US
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Telephone | 201-690-1764
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Fax | 971-891-0763
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00467600
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License Number State | NJ
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