Provider Demographics
NPI:1467029363
Name:PEPE, ANNA VERONICA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:VERONICA
Last Name:PEPE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 WINTHROP DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3551
Mailing Address - Country:US
Mailing Address - Phone:908-208-7519
Mailing Address - Fax:
Practice Address - Street 1:3010 BORDENTOWN AVE STE B2
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1181
Practice Address - Country:US
Practice Address - Phone:908-208-7519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054143001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty