Provider Demographics
NPI:1437220787
Name:POLIZOTTO, JENNIFER (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:POLIZOTTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BALFOUR LN
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2606
Mailing Address - Country:US
Mailing Address - Phone:201-675-1540
Mailing Address - Fax:
Practice Address - Street 1:145 N FRANKLIN TPKE
Practice Address - Street 2:SUITE 321
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1602
Practice Address - Country:US
Practice Address - Phone:201-675-1540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05296000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker