Provider Demographics
NPI:1255578779
Name:GREENAGEL, FRANK LOUIS JR (LCSW, LCADC, CJC)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:LOUIS
Last Name:GREENAGEL
Suffix:JR
Gender:M
Credentials:LCSW, LCADC, CJC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5801
Mailing Address - Country:US
Mailing Address - Phone:908-268-6004
Mailing Address - Fax:
Practice Address - Street 1:144 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3086
Practice Address - Country:US
Practice Address - Phone:908-268-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05449001041C0700X
NJ37LC000151300101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)