Healthcare Provider Details

I. General information

NPI: 1306651419
Provider Name (Legal Business Name): SKYLAR WERNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 EVELYN ST FL 3
PARAMUS NJ
07652-2901
US

IV. Provider business mailing address

401 AVALON DR UNIT 4303
WOOD RIDGE NJ
07075-1060
US

V. Phone/Fax

Practice location:
  • Phone: 201-977-2889
  • Fax:
Mailing address:
  • Phone: 201-257-7819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL07240900
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: