| Jacqueline Elizabeth Carroll, | |
|
444 Warren St Apt 357, Jersey City, NJ 07302-7201 | |
| (551) 655-0006 | |
| (201) 567-9335 |
| Full Name | Jacqueline Elizabeth Carroll |
|---|---|
| Gender | Female |
| Speciality | Marriage & Family Therapist |
| Location | 444 Warren St Apt 357, Jersey City, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629560784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 37FA00015600 (New Jersey) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| Entity Name | Forge Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962175026 PECOS PAC ID: 5597163949 Enrollment ID: O20211015000010 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline Elizabeth Carroll, 444 Warren St Apt 357, Jersey City, NJ 07302-7201 Ph: (551) 655-0006 | Jacqueline Elizabeth Carroll, 444 Warren St Apt 357, Jersey City, NJ 07302-7201 Ph: (551) 655-0006 |
Hillary Geffner, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 111 Town Square Pl, Ste 1201, Pmb 1023, Jersey City, NJ 07310 Phone: 646-820-5674 | |
Mr. Jacob Hernandez, LAC Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 176 Palisade Ave, Jersey City, NJ 07306 Phone: 201-795-8200 | |
Candice Claire Ebbesen, MA, EDS MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 104 Wayne St, Jersey City, NJ 07302 Phone: 201-780-0905 Fax: 973-673-5782 | |
Dr. Louis J Scurti, PH.D., ED.S., M.DIV. Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 56 Glenwood Ave Apt 1, Jersey City, NJ 07306 Phone: 973-981-5003 | |
Ms. Sydney Danielle Burney, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 525 Washington Blvd Ste 300, Jersey City, NJ 07310 Phone: 347-212-0382 | |
Glenda N Guevara, MA, LAMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 75 Lee Ct, Jersey City, NJ 07305 Phone: 732-795-0850 | |
Ms. Ursula Saunders, MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 104 Tidewater St Apt 1a, Jersey City, NJ 07302 Phone: 203-858-8063 |