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General NPI Number Information
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NPI Number | 1790441673
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Entity Type | Individual
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Provider Name | PAULINE PERNINI LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/15/2021
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 134 MAIN ST STE 3A
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City | FLEMINGTON
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State | NJ
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Zip | 08822-1694
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Country | US
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Telephone | 908-892-4517
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Fax |
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Provider Business Mailing Address
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Address Line | 134 MAIN ST STE 3A
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City | FLEMINGTON
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State | NJ
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Zip | 08822-1694
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Country | US
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Telephone | 908-892-4517
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SCO4549800
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License Number State | NJ
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