Provider Demographics
NPI:1689700858
Name:SAAKE, DENNIS JOHN (LCSW)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:JOHN
Last Name:SAAKE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-3026
Mailing Address - Country:US
Mailing Address - Phone:732-223-2730
Mailing Address - Fax:732-449-1646
Practice Address - Street 1:61 COLBY AVE
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-3026
Practice Address - Country:US
Practice Address - Phone:732-223-2730
Practice Address - Fax:732-449-1646
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000094001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical