Provider Demographics
NPI:1124390604
Name:PENA, ARIANA MERCEDEZ (LSW)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:MERCEDEZ
Last Name:PENA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SAFRAN AVE
Mailing Address - Street 2:CATHOLIC CHARITIES, DIOCESE OF METUCHEN
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3510
Mailing Address - Country:US
Mailing Address - Phone:732-738-1323
Mailing Address - Fax:732-738-3896
Practice Address - Street 1:288 RUES LN
Practice Address - Street 2:CATHOLIC CHARITIES, DIOCESE OF METUCHEN
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5699
Practice Address - Country:US
Practice Address - Phone:732-257-6100
Practice Address - Fax:732-651-9834
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05740100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker