Provider Demographics
NPI:1235451519
Name:GUEVARA, THERESA SABATER (MSW)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:SABATER
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 LEFFERTS LN
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-2303
Mailing Address - Country:US
Mailing Address - Phone:732-381-1044
Mailing Address - Fax:
Practice Address - Street 1:87 LEFFERTS LN
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-2303
Practice Address - Country:US
Practice Address - Phone:732-381-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-27
Last Update Date:2010-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013624001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical