Provider Demographics
NPI:1770857344
Name:WYKA, GLORIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:
Last Name:WYKA
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 1:7 INDUSTRIAL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:PEQUANNOCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07440-1901
Mailing Address - Country:US
Mailing Address - Phone:201-709-6548
Mailing Address - Fax:
Practice Address - Street 1:7 INDUSTRIAL RD STE 206
Practice Address - Street 2:
Practice Address - City:PEQUANNOCK
Practice Address - State:NJ
Practice Address - Zip Code:07440-1901
Practice Address - Country:US
Practice Address - Phone:201-709-6548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054253001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical