Healthcare Provider Details

I. General information

NPI: 1467029363
Provider Name (Legal Business Name): ANNA VERONICA PEPE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 06/08/2021
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 BORDENTOWN AVE STE B2
PARLIN NJ
08859-1181
US

IV. Provider business mailing address

37 WINTHROP DR
MANALAPAN NJ
07726-3551
US

V. Phone/Fax

Practice location:
  • Phone: 908-208-7519
  • Fax:
Mailing address:
  • Phone: 908-208-7519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05414300
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: