Healthcare Provider Details

I. General information

NPI: 1164068870
Provider Name (Legal Business Name): ANNA PARDENEK MA, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2019
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 STRAUBE CENTER BLVD STE F-115
PENNINGTON NJ
08534-1497
US

IV. Provider business mailing address

106 STRAUBE CENTER BLVD STE F-115
PENNINGTON NJ
08534-1497
US

V. Phone/Fax

Practice location:
  • Phone: 609-336-3012
  • Fax:
Mailing address:
  • Phone: 609-336-3012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC01001300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: