Provider Demographics
NPI:1003146150
Name:ACKER, AMY B (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:ACKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 US HIGHWAY 202/206
Mailing Address - Street 2:BUILDING 3, SUITE 106
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1747
Mailing Address - Country:US
Mailing Address - Phone:973-769-2401
Mailing Address - Fax:
Practice Address - Street 1:672 US HIGHWAY 202/206
Practice Address - Street 2:BUILDING 3, SUITE 106
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1747
Practice Address - Country:US
Practice Address - Phone:973-769-2401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054076001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical