Provider Demographics
NPI:1245523083
Name:NEDELKA, ANNE (LPC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:NEDELKA
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 1:55 NEWTON SPARTA RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2772
Mailing Address - Country:US
Mailing Address - Phone:973-600-9032
Mailing Address - Fax:973-579-9392
Practice Address - Street 1:55 NEWTON SPARTA RD
Practice Address - Street 2:SUITE 104
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2772
Practice Address - Country:US
Practice Address - Phone:973-600-9032
Practice Address - Fax:973-579-9392
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00282800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional