Provider Demographics
NPI:1871848556
Name:PLACENCIA-BLOCK, ANA ISABEL (LCSW)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ISABEL
Last Name:PLACENCIA-BLOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:ISABEL
Other - Last Name:PLACENCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6601 VENTNOR AVE STE 16 B
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-1054
Mailing Address - Country:US
Mailing Address - Phone:269-876-9694
Mailing Address - Fax:
Practice Address - Street 1:6601 VENTNOR AVE STE 16 B
Practice Address - Street 2:
Practice Address - City:VENTNOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08406-1054
Practice Address - Country:US
Practice Address - Phone:269-876-9694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055087001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical