Healthcare Provider Details

I. General information

NPI: 1255973137
Provider Name (Legal Business Name): BEVERLY PIPARO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2019
Last Update Date: 10/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 MAIN ST
HACKENSACK NJ
07601-4847
US

IV. Provider business mailing address

217 NORMAN DR
RAMSEY NJ
07446-2670
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-6728
  • Fax: 201-633-7361
Mailing address:
  • Phone: 551-804-9229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC01273300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: