MEDICARE: VICTOR JOSEPH ROVEDA LPC

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	101YP2500X	Professional Counselor	37PC00670900	NJ

General Provider Information

NPI Number	:	1770298937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR JOSEPH ROVEDA LPC

Provider Business Mailing Address
First Line	:	1144 CENTRAL AVE
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2233
Country	:	US
Telephone Number	:	201-655-3681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1144 CENTRAL AVE
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2233
Country	:	US
Telephone Number	:	201-655-3681
Fax Number	:

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

Provider Enumeration Date	:	01/20/2023
Last Update Date	:	03/01/2023

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