Provider Demographics
NPI:1346372935
Name:PEDEVILLANO, ROBERT ANGELO (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ANGELO
Last Name:PEDEVILLANO
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 NORTH AVE E
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2196
Mailing Address - Country:US
Mailing Address - Phone:908-230-5554
Mailing Address - Fax:908-272-5696
Practice Address - Street 1:23 NORTH AVE E
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2196
Practice Address - Country:US
Practice Address - Phone:908-230-5554
Practice Address - Fax:908-272-5696
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00052300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional