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General NPI Number Information
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NPI Number | 1639647837
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Entity Type | Individual
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Provider Name | JESSICA GRACE THALHAMER DC, LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 2 UNIVERSITY PLZ STE 100
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City | HACKENSACK
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State | NJ
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Zip | 07601-6210
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Country | US
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Telephone | 631-834-8647
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Fax |
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Provider Business Mailing Address
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Address Line | 2 UNIVERSITY PLZ STE 100
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City | HACKENSACK
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State | NJ
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Zip | 07601-6210
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Country | US
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Telephone | 631-834-8647
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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 | 12313-C
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14334
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2371289
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC06423900
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC24034
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License Number State | ME
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Taxonomy #6
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 013113
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14251829-3501
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License Number State | UT
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Taxonomy #8
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 097116
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License Number State | NY
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