Provider Demographics
NPI:1124200530
Name:KACPROWICZ, DARENE (MA)
Entity Type:Individual
Prefix:
First Name:DARENE
Middle Name:
Last Name:KACPROWICZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 TAKOLUSA DR
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1259
Mailing Address - Country:US
Mailing Address - Phone:732-530-2438
Mailing Address - Fax:
Practice Address - Street 1:63 TAKOLUSA DR
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1259
Practice Address - Country:US
Practice Address - Phone:732-530-2438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00188000101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor