Provider Demographics
NPI:1336287606
Name:MONACCHIO, RICHARD W (LCSW)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:MONACCHIO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 STRAUBE CENTER BLVD
Mailing Address - Street 2:STE K 1,8
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-1450
Mailing Address - Country:US
Mailing Address - Phone:609-737-8850
Mailing Address - Fax:
Practice Address - Street 1:114 STRAUBE CENTER BLVD
Practice Address - Street 2:STE K 1,8
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-1450
Practice Address - Country:US
Practice Address - Phone:609-737-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC047293001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical