Provider Demographics
NPI:1518667989
Name:ACKERMANN-BLANCO, ANA PATRICIA (MA, LCADC, CSW, CCS)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:PATRICIA
Last Name:ACKERMANN-BLANCO
Suffix:
Gender:F
Credentials:MA, LCADC, CSW, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 US HIGHWAY 46 WEST
Mailing Address - Street 2:STE 140W
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2361
Mailing Address - Country:US
Mailing Address - Phone:201-669-4674
Mailing Address - Fax:973-464-6842
Practice Address - Street 1:322 US HIGHWAY 46 STE 140W
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-2361
Practice Address - Country:US
Practice Address - Phone:201-669-4674
Practice Address - Fax:973-464-6842
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SW00719300104100000X
NJ37LC00143700101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker