Provider Demographics
NPI:1568979367
Name:JEANBAPTISTE, ARCHANA PILLAI (LCSW)
Entity Type:Individual
Prefix:
First Name:ARCHANA
Middle Name:PILLAI
Last Name:JEANBAPTISTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ARCHANA
Other - Middle Name:PILLAI
Other - Last Name:JEANBAPTISTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:61 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1832
Mailing Address - Country:US
Mailing Address - Phone:908-514-8590
Mailing Address - Fax:908-889-5619
Practice Address - Street 1:61 PEARL ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1832
Practice Address - Country:US
Practice Address - Phone:908-514-8590
Practice Address - Fax:908-889-5619
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051284001041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0018244Medicaid