Organization
EVALUATIONS FOR CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNELL JACKSON LCSW (OWNER)
(732) 784-8336
Entity
Organization
Contact information
Practice address
130 W WATER ST UNIT 1287, TOMS RIVER, NJ 08754-8049
(732) 784-8336
Mailing address
130 W WATER ST UNIT 1287, TOMS RIVER, NJ 08754-8049
(732) 784-8336
(732) 858-5651
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/12/2024
Last updated
11/04/2024
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