Provider Demographics
NPI:1457678476
Name:GANCARZ-DEMARCO, VALERIE ELIZABETH (MA, MSW, LSW, BCBA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ELIZABETH
Last Name:GANCARZ-DEMARCO
Suffix:
Gender:F
Credentials:MA, MSW, LSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-2507
Mailing Address - Country:US
Mailing Address - Phone:201-715-6173
Mailing Address - Fax:201-505-0892
Practice Address - Street 1:251 KNOLL DR
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656-2507
Practice Address - Country:US
Practice Address - Phone:201-715-6173
Practice Address - Fax:201-505-0892
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-03-1293103K00000X
NJ44SL04851800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker