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Organization
OUR SPACE NORTHEAST
Active
Organization
OUR SPACE NORTHEAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE COLLARD DSW, LCSW (OWNER/LCSW)
(908) 721-6728
Entity
Organization
Contact information
Practice address
88 W RIDGEWOOD AVE, RIDGEWOOD, NJ 07450-3199
(201) 714-0820
Mailing address
130 W PLEASANT AVE STE 85, MAYWOOD, NJ 07607-1335
(201) 714-0820
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/14/2026
Last updated
08/14/2026
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