MEDICARE: MS. JAMIE GREENSPAN MSW, LCSW, LCADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	37LC00076500	NJ
2	1041C0700X	Clinical Social Worker	44SC05210500	NJ

General Provider Information

NPI Number	:	1497726087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JAMIE GREENSPAN MSW, LCSW, LCADC

Provider Business Mailing Address
First Line	:	1205 HWY 35
Second Line	:
City	:	OCEAN
State	:	NJ
Zip	:	07712-4077
Country	:	US
Telephone Number	:	732-272-6672
Fax Number	:

Provider Business Practice Location Address
First Line	:	BUILDING 5203 MARYLAND AVENUE
Second Line	:	ARMY SUBSTANCE ABUSE PROGRAM
City	:	FORT DIX
State	:	NJ
Zip	:	08640
Country	:	US
Telephone Number	:	609-562-4011
Fax Number	:

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	12/22/2011

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