Provider Demographics
NPI:1972715084
Name:VICARI APPLEHEIMER, ANNETTE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:
Last Name:VICARI APPLEHEIMER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 RICHMOND AVE
Mailing Address - Street 2:SUITE104
Mailing Address - City:POINT PLEASANT BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:08742
Mailing Address - Country:US
Mailing Address - Phone:732-701-9860
Mailing Address - Fax:732-295-2280
Practice Address - Street 1:1101 RICHMOND AVE
Practice Address - Street 2:SUITE104
Practice Address - City:POINT PLEASANT BEACH
Practice Address - State:NJ
Practice Address - Zip Code:08742
Practice Address - Country:US
Practice Address - Phone:732-701-9860
Practice Address - Fax:732-295-2280
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00311300103TA0700X, 103TC1900X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3113OtherPSYCHOLOGIST LICENSE
NJ444278Medicare ID - Type Unspecified