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General NPI Number Information
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NPI Number | 1881556249
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Entity Type | Individual
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Provider Name | JESSICA RAIMONDO MA,NCC,LAC
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 200 MIDDLESEX ESSEX TPKE STE 304
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City | ISELIN
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State | NJ
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Zip | 08830-2033
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Country | US
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Telephone | 732-455-2343
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MIDDLESEX ESSEX TPKE STE 304
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City | ISELIN
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State | NJ
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Zip | 08830-2033
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37AC00810200
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License Number State | NJ
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