Provider Demographics
NPI:1376750463
Name:PAZIENZA, CAMILLE V (LCSW, MA)
Entity Type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:V
Last Name:PAZIENZA
Suffix:
Gender:F
Credentials:LCSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1302
Mailing Address - Country:US
Mailing Address - Phone:973-715-6315
Mailing Address - Fax:973-662-1185
Practice Address - Street 1:349 FRANKLIN AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-4004
Practice Address - Country:US
Practice Address - Phone:973-715-6315
Practice Address - Fax:973-662-1185
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052545001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical