MEDICARE: JENNIFER M. PRIDDY, LLC

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	054404	NY
2	1041C0700X	Clinical Social Worker	44SC05159300	NJ

General Provider Information

NPI Number	:	1619155660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIFER M. PRIDDY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 33
Second Line	:
City	:	DENVILLE
State	:	NJ
Zip	:	07834-0033
Country	:	US
Telephone Number	:	973-540-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3210 SCENIC CT
Second Line	:
City	:	DENVILLE
State	:	NJ
Zip	:	07834-3481
Country	:	US
Telephone Number	:	973-540-1600
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MS. JENNIFER M. PRIDDY
Credential	:	LCSW
Telephone Number	:	973-540-1600

Provider Enumeration Date	:	02/01/2008
Last Update Date	:	02/25/2026

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