Provider Demographics
NPI:1851099261
Name:VERGE, HANNA (LPC)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:VERGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2136 HOLLYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-3827
Mailing Address - Country:US
Mailing Address - Phone:609-290-9726
Mailing Address - Fax:
Practice Address - Street 1:712 E BAY AVE STE 21-C
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3447
Practice Address - Country:US
Practice Address - Phone:609-756-5327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00925900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional