Provider Demographics
NPI:1548280563
Name:STULL, JENNIFER LYNNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNNE
Last Name:STULL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LYNNE
Other - Last Name:SCHIED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:55 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2225
Mailing Address - Country:US
Mailing Address - Phone:908-280-1957
Mailing Address - Fax:908-291-1212
Practice Address - Street 1:55 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2225
Practice Address - Country:US
Practice Address - Phone:908-280-1957
Practice Address - Fax:908-291-1212
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052500001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical