Provider Demographics
NPI:1972677110
Name:TULLY, APRIL ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:APRIL
Middle Name:ELIZABETH
Last Name:TULLY
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 1:899 BOULEVARD EAST
Mailing Address - Street 2:#8L
Mailing Address - City:WEEHAWKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07086
Mailing Address - Country:US
Mailing Address - Phone:201-348-3634
Mailing Address - Fax:
Practice Address - Street 1:271 ROUTE 46 WEST
Practice Address - Street 2:FAIRFIELD COMMONS SUITE H 101
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004
Practice Address - Country:US
Practice Address - Phone:201-424-1233
Practice Address - Fax:973-575-9559
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046930001041C0700X
NY05351211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2645121OtherOXFORD
NJ020594Medicare ID - Type Unspecified