MEDICARE: LARISSA VARELA LSW

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	44SL06409300	NJ

General Provider Information

NPI Number	:	1952112898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARISSA VARELA LSW

Provider Business Mailing Address
First Line	:	440 WHITON RD
Second Line	:
City	:	BRANCHBURG
State	:	NJ
Zip	:	08853-4202
Country	:	US
Telephone Number	:	908-239-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 DIVISION ST FL 3
Second Line	:
City	:	SOMERVILLE
State	:	NJ
Zip	:	08876-2943
Country	:	US
Telephone Number	:	908-704-0011
Fax Number	:

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

Provider Enumeration Date	:	01/20/2025
Last Update Date	:	01/20/2025

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Directions to “ LARISSA VARELA LSW” Practice Location

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