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NPI Code Detail

MEDICARE: MRS. BEVERLY ANNE KOLSKY MSW, LCSW, BCD-P.

MEDICARE:  MRS. BEVERLY ANNE KOLSKY  MSW, LCSW, BCD-P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1102L00000XPsychoanalyst44SC00196100NJ
2104100000XSocial Worker

General Provider Information

NPI Number : 1053568907
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BEVERLY ANNE KOLSKY MSW, LCSW, BCD-P.
Provider Business Mailing Address
First Line : 163 ENGLE ST.
Second Line : BLDG 5
City : ENGLEWOOD
State : NJ
Zip : 07631
Country : US
Telephone Number : 201-894-5499
Fax Number : 201-692-9219
Provider Business Practice Location Address
First Line : 163 ENGLE ST.
Second Line : BLDG 5
City : ENGLEWOOD
State : NJ
Zip : 07631
Country : US
Telephone Number : 201-894-5499
Fax Number : 201-692-9219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2008
Last Update Date : 08/22/2008

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Directions to “ MRS. BEVERLY ANNE KOLSKY MSW, LCSW, BCD-P.” Practice Location

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