Provider Demographics
NPI:1376745364
Name:JAVIER, NAZARENO C (LCSW)
Entity Type:Individual
Prefix:MR
First Name:NAZARENO
Middle Name:C
Last Name:JAVIER
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 1:52 SAINT DUNSTANS RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-4526
Mailing Address - Country:US
Mailing Address - Phone:267-221-9382
Mailing Address - Fax:215-956-7155
Practice Address - Street 1:52 SAINT DUNSTANS RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-4526
Practice Address - Country:US
Practice Address - Phone:267-221-9382
Practice Address - Fax:215-956-7155
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0155741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical