MEDICARE: MICHAEL JONATHAN PERAL LCSW

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
1	1041C0700X	Clinical Social Worker	44SL07030500	NJ

General Provider Information

NPI Number	:	1164294641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JONATHAN PERAL LCSW

Provider Business Mailing Address
First Line	:	859 US HIGHWAY 130 UNIT 1127
Second Line	:
City	:	EAST WINDSOR
State	:	NJ
Zip	:	08520-2900
Country	:	US
Telephone Number	:	201-800-5435
Fax Number	:

Provider Business Practice Location Address
First Line	:	859 US HIGHWAY 130 UNIT 1127
Second Line	:
City	:	EAST WINDSOR
State	:	NJ
Zip	:	08520-2900
Country	:	US
Telephone Number	:	201-800-5435
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2023
Last Update Date	:	01/20/2026

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