Provider Demographics
NPI:1255670055
Name:DEPKO, PATRICIA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ELIZABETH
Last Name:DEPKO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 DRUM POINT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6376
Mailing Address - Country:US
Mailing Address - Phone:732-977-5050
Mailing Address - Fax:
Practice Address - Street 1:270 DRUM POINT RD STE 201
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6376
Practice Address - Country:US
Practice Address - Phone:732-977-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013789001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical