Provider Demographics
NPI:1225274830
Name:GLORIA T. PAKNIS, MSW, LLC
Entity Type:Organization
Organization Name:GLORIA T. PAKNIS, MSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:PAKNIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-377-3966
Mailing Address - Street 1:37 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-2500
Mailing Address - Country:US
Mailing Address - Phone:973-377-3966
Mailing Address - Fax:973-377-5931
Practice Address - Street 1:37 KINGS RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2500
Practice Address - Country:US
Practice Address - Phone:973-377-3966
Practice Address - Fax:973-377-5931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001760001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty