Provider Demographics
NPI:1760512859
Name:NANN, ANNETTE STELLA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:STELLA
Last Name:NANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 AMHERST LN
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-2318
Mailing Address - Country:US
Mailing Address - Phone:732-264-9534
Mailing Address - Fax:732-264-1124
Practice Address - Street 1:6 AMHERST LN
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-2318
Practice Address - Country:US
Practice Address - Phone:732-264-9534
Practice Address - Fax:732-264-1124
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051949001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical