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General NPI Number Information
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NPI Number | 1275993941
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Entity Type | Individual
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Provider Name | JIMMY PASSE LPC
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Gender | Male
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 2 PARAGON WAY, SUITE 800
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-393-8391
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Fax | 732-561-1721
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Provider Business Mailing Address
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Address Line | 2 PARAGON WAY, SUITE 800
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-393-8391
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Fax | 732-561-1721
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00186400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00533300
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License Number State | NJ
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