Provider Demographics
NPI:1346379724
Name:VERNER, PATRICE JULIET (MA,LPC)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:JULIET
Last Name:VERNER
Suffix:
Gender:F
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 IRVINGTON AVE
Mailing Address - Street 2:UNIT 201
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2276
Mailing Address - Country:US
Mailing Address - Phone:973-763-1394
Mailing Address - Fax:
Practice Address - Street 1:153 IRVINGTON AVE
Practice Address - Street 2:UNIT 201
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2276
Practice Address - Country:US
Practice Address - Phone:973-763-1394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00056200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional