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General NPI Number Information
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NPI Number | 1821147554
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Entity Type | Individual
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Provider Name | GINA MARIE UNGER LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 562 KINGSLAND ST
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City | NUTLEY
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State | NJ
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Zip | 07110-1069
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Country | US
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Telephone | 973-930-5507
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Fax | 973-860-1326
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Provider Business Mailing Address
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Address Line | 48 PINE DR
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City | CEDAR GROVE
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State | NJ
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Zip | 07009-1036
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Country | US
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Telephone | 973-890-8637
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Fax | 973-860-1326
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC00041300
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License Number State | NJ
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