Healthcare Provider Details

I. General information

NPI: 1891931317
Provider Name (Legal Business Name): ANNETTE VICARI APPLEHEIMER, PSY.D.,L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 RICHMOND AVE SUITE 104
POINT PLEASANT BEACH NJ
08742-3010
US

IV. Provider business mailing address

1101 RICHMOND AVE SUITE 104
POINT PLEASANT BEACH NJ
08742-3010
US

V. Phone/Fax

Practice location:
  • Phone: 732-701-9860
  • Fax:
Mailing address:
  • Phone: 732-701-9860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number35S100311300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35S100311300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number35S100311300
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number35S100311300
License Number StateNJ

VIII. Authorized Official

Name: DR. ANNETTE VICARI APPLEHEIMER
Title or Position: REGISTERED AGENT
Credential: PSY.D.
Phone: 732-701-9860