Provider Demographics
NPI:1063848794
Name:PORCELLI, BARBARA A (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:PORCELLI
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 1:546 HIGH MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2606
Mailing Address - Country:US
Mailing Address - Phone:201-981-6952
Mailing Address - Fax:973-423-2019
Practice Address - Street 1:546 HIGH MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2606
Practice Address - Country:US
Practice Address - Phone:201-981-6952
Practice Address - Fax:973-423-2019
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051936001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical