Provider Demographics
NPI:1073857074
Name:TEPER, AGNIESZKA (LCSW)
Entity Type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:TEPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AGNES
Other - Middle Name:
Other - Last Name:TEPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:51 ALBERT STREET
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 RT 17 NORTH
Practice Address - Street 2:SUITE 312
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-445-1990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055017001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical