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General NPI Number Information
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NPI Number | 1558767756
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Entity Type | Individual
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Provider Name | JILL FELLNER L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2014
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 550 KINDERKAMACK RD STE 2
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City | ORADELL
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State | NJ
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Zip | 07649-1500
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Country | US
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Telephone | 201-749-0065
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Fax |
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Provider Business Mailing Address
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Address Line | 107 HAWTHORNE AVE APT E
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City | PARK RIDGE
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State | NJ
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Zip | 07656-3205
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Country | US
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Telephone | 917-478-5669
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05600000
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License Number State | NJ
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