Provider Demographics
NPI:1003267220
Name:TIWARI, DEEPANJALI (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:DEEPANJALI
Middle Name:
Last Name:TIWARI
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 VILLAGE BLVD STE 200
Mailing Address - Street 2:#2892
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5700
Mailing Address - Country:US
Mailing Address - Phone:908-800-2225
Mailing Address - Fax:
Practice Address - Street 1:116 VILLAGE BLVD STE 200
Practice Address - Street 2:#2892
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5700
Practice Address - Country:US
Practice Address - Phone:908-800-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)