| Doctor Name: | JASON O'DONNELL |
| NPI Number: | 1033557137 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 28127 |
| Business Practice Address: | 39 Avenue At The Cmn Suite 106 Shrewsbury, NJ - 077024807 |
| Business Phone Number: | 7329431326 |
| Business Fax Number: | 7328657190 |
| Mailing Address: | 39 Avenue At The Cmn, Suite 106 SHREWSBURY |
| State: | NJ |
| Postal Code: | 077024807 |
| Phone Number: | 7329431326 |
| Fax Number: | 7328657190 |
| NPI Enumeration Date: | 06/11/2013 |
| NPI Last Update Date: | 10/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 28127 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |