MEDICARE: MS. JACQUELINE AMORELLI LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC05319300	NJ
2	1041C0700X	Clinical Social Worker		NJ

General Provider Information

NPI Number	:	1114295953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JACQUELINE AMORELLI LCSW

Provider Business Mailing Address
First Line	:	305 SOUTH ST
Second Line	:
City	:	BRIELLE
State	:	NJ
Zip	:	08730-1528
Country	:	US
Telephone Number	:	908-309-5891
Fax Number	:

Provider Business Practice Location Address
First Line	:	2340 ROUTE 9 STE A2
Second Line	:
City	:	HOWELL
State	:	NJ
Zip	:	07731-4016
Country	:	US
Telephone Number	:	908-309-5891
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2011
Last Update Date	:	11/05/2024

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