Provider Demographics
NPI:1235996042
Name:ALVERNA, BERVELY (LSW)
Entity Type:Individual
Prefix:
First Name:BERVELY
Middle Name:
Last Name:ALVERNA
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 1:349 FRANKLIN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1645
Mailing Address - Country:US
Mailing Address - Phone:973-931-1234
Mailing Address - Fax:
Practice Address - Street 1:349 FRANKLIN AVE STE 202
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1645
Practice Address - Country:US
Practice Address - Phone:973-931-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06981000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker