Provider Demographics
NPI:1356374318
Name:CACACIE, WENDY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:CACACIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 ALEXANDER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6331
Mailing Address - Country:US
Mailing Address - Phone:609-987-8100
Mailing Address - Fax:609-987-0574
Practice Address - Street 1:707 ALEXANDER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6331
Practice Address - Country:US
Practice Address - Phone:609-987-8100
Practice Address - Fax:609-987-0574
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003514001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical