Healthcare Provider Details

I. General information

NPI: 1891627543
Provider Name (Legal Business Name): CARLEY ANNE TSAGLOS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 HACKENSACK AVE
HARRINGTON PARK NJ
07640-1314
US

IV. Provider business mailing address

51 HACKENSACK AVE
HARRINGTON PARK NJ
07640-1314
US

V. Phone/Fax

Practice location:
  • Phone: 201-394-2955
  • Fax:
Mailing address:
  • Phone: 201-394-2955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number073468-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: