Provider Demographics
NPI:1548702541
Name:CARVALHO, JAMIE LYNN (MA, LPC, LCADC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:CARVALHO
Suffix:
Gender:F
Credentials:MA, LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HANOVER ROAD
Mailing Address - Street 2:BLDG B SUITE 100
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1209
Mailing Address - Country:US
Mailing Address - Phone:973-544-8483
Mailing Address - Fax:
Practice Address - Street 1:25 HANOVER ROAD
Practice Address - Street 2:BLDG B SUITE 100
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1209
Practice Address - Country:US
Practice Address - Phone:973-544-8483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00224000101YA0400X
NJ37PC00660900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)