Provider Demographics
NPI:1134314404
Name:SEGAL, BEATRICE (LCSW, NP)
Entity Type:Individual
Prefix:MRS
First Name:BEATRICE
Middle Name:
Last Name:SEGAL
Suffix:
Gender:F
Credentials:LCSW, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5326
Mailing Address - Country:US
Mailing Address - Phone:201-265-3310
Mailing Address - Fax:201-265-8219
Practice Address - Street 1:184 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5326
Practice Address - Country:US
Practice Address - Phone:201-265-3310
Practice Address - Fax:201-265-8219
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004882001041C0700X
NJNC17357363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner