Provider Demographics
NPI:1871109314
Name:INFANTE, JEANNIE (LMSW)
Entity type:Individual
Prefix:
First Name:JEANNIE
Middle Name:
Last Name:INFANTE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 S DEMAREST AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-2010
Mailing Address - Country:US
Mailing Address - Phone:646-702-6494
Mailing Address - Fax:
Practice Address - Street 1:42 S DEMAREST AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-2010
Practice Address - Country:US
Practice Address - Phone:646-702-6494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL067636001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical