Individual
JENNIFER ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, PMH-C
Contact information
Practice address
98 BURNETT AVE APT 2C, MAPLEWOOD, NJ 07040-3159
(973) 519-1247
Mailing address
4 S ORANGE AVE, PMB #1208, SOUTH ORANGE, NJ 07079
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05674400
NJ
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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