=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154319382
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JILL L. PREIS LCSW,CADC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/11/2005
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7 WEASEL DRIFT RD
-----------------------------------------------------
City | WEST PATERSON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07424-2762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-925-8989
-----------------------------------------------------
Fax | 973-742-0175
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7 WEASEL DRIFT RD
-----------------------------------------------------
City | WEST PATERSON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07424-2762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-925-8989
-----------------------------------------------------
Fax | 973-742-0175
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 1994R
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 44SC00763800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1041S0200X
-----------------------------------------------------
Taxonomy Name | School Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------