Individual
JERRI SHANKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW LCSW LCADC
Contact information
Practice address
339 CHANGEBRIDGE RD STE 1A, PINE BROOK, NJ 07058-9577
(201) 452-1432
(973) 808-0089
Mailing address
25 VALLEY DR, GLENWOOD, NJ 07418-1657
(201) 452-1432
(973) 808-0089
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00071500
NJ
1041C0700X
Clinical Social Worker
Primary
44SC04391600
NJ
Other
Enumeration date
08/14/2006
Last updated
04/29/2010
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