Provider Demographics
NPI:1972830230
Name:SON, ANGELA SEJUNG (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:SEJUNG
Last Name:SON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SEJUNG
Other - Middle Name:
Other - Last Name:SON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:610 VALLEY HEALTH PLZ
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3607
Mailing Address - Country:US
Mailing Address - Phone:718-358-8288
Mailing Address - Fax:718-358-5265
Practice Address - Street 1:610 VALLEY HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3607
Practice Address - Country:US
Practice Address - Phone:201-265-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002358103K00000X
1-21-54639103K00000X
NJ44SC057388001041C0700X
1041C0700X, 390200000X
NY0862941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program