Provider Demographics
NPI:1558533729
Name:BERTELLI, JANET ANNE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ANNE
Last Name:BERTELLI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 E ALLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-2017
Mailing Address - Country:US
Mailing Address - Phone:201-825-1835
Mailing Address - Fax:201-818-5012
Practice Address - Street 1:74 E ALLENDALE AVE
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-2017
Practice Address - Country:US
Practice Address - Phone:201-825-1835
Practice Address - Fax:201-818-5012
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004519001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
640709Medicare PIN