Provider Demographics
NPI:1144786963
Name:WARRAICH-GIBSON, EMAN (LCSW, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:EMAN
Middle Name:
Last Name:WARRAICH-GIBSON
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:EMAN
Other - Middle Name:
Other - Last Name:WARRAICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:609 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2635
Mailing Address - Country:US
Mailing Address - Phone:973-558-9444
Mailing Address - Fax:
Practice Address - Street 1:103 LINCOLN PARK
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2388
Practice Address - Country:US
Practice Address - Phone:201-617-2760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-17
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00232700101YA0400X
NJ44SC056399001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)