Provider Demographics
NPI:1851697288
Name:KEPICOVA, MARCELA (LPC)
Entity Type:Individual
Prefix:PROF
First Name:MARCELA
Middle Name:
Last Name:KEPICOVA
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 1:58 NORMANDY RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3108
Mailing Address - Country:US
Mailing Address - Phone:973-653-6382
Mailing Address - Fax:
Practice Address - Street 1:58 NORMANDY RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3108
Practice Address - Country:US
Practice Address - Phone:973-653-6382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00417600101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor