MEDICARE: MR. WARREN VERVERS MSW, LCSW, C-ASWCM

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	44SC00221600	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841326881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WARREN VERVERS MSW, LCSW, C-ASWCM

Provider Business Mailing Address
First Line	:	12 ELDRIDGE ROAD
Second Line	:	P. O. BOX 330
City	:	MOUNT TABOR
State	:	NJ
Zip	:	07878
Country	:	US
Telephone Number	:	973-349-8647
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 ELDRIDGE ROAD
Second Line	:
City	:	MOUNT TABOR
State	:	NJ
Zip	:	07878
Country	:	US
Telephone Number	:	973-349-8647
Fax Number	:

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/09/2007

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