Provider Demographics
NPI:1245538107
Name:SEGELBACHER, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:SEGELBACHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:SEGELBACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:372 KINDERKAMACK RD
Mailing Address - Street 2:SUITE2
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-1653
Mailing Address - Country:US
Mailing Address - Phone:201-370-4585
Mailing Address - Fax:
Practice Address - Street 1:372 KINDERKAMACK RD
Practice Address - Street 2:SUITE2
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-1653
Practice Address - Country:US
Practice Address - Phone:201-370-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053736001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical