Healthcare Provider Details

I. General information

NPI: 1073950317
Provider Name (Legal Business Name): EMILY ROVAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2013
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 ROUTE 22 STE 3D
BRIDGEWATER NJ
08807-2949
US

IV. Provider business mailing address

19 ALLEN AVE
MANASQUAN NJ
08736-3401
US

V. Phone/Fax

Practice location:
  • Phone: 908-231-0511
  • Fax:
Mailing address:
  • Phone: 732-233-2982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44SC06122200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: