Provider Demographics
NPI:1679664650
Name:VERRECCHIA, ANNE MARIE JULIA (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE MARIE
Middle Name:JULIA
Last Name:VERRECCHIA
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:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07462-0432
Mailing Address - Country:US
Mailing Address - Phone:973-769-7184
Mailing Address - Fax:973-875-4983
Practice Address - Street 1:112 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4489
Practice Address - Country:US
Practice Address - Phone:201-447-5565
Practice Address - Fax:973-875-4983
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003079001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
038081Medicare ID - Type Unspecified