Provider Demographics
NPI:1457552861
Name:MERTENS, NANCY INTILLI (MS, LPC, ATR-BC)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:INTILLI
Last Name:MERTENS
Suffix:
Gender:F
Credentials:MS, LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 INDEPENDENCE WAY
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-5441
Mailing Address - Country:US
Mailing Address - Phone:201-320-5841
Mailing Address - Fax:
Practice Address - Street 1:149 AVENUE AT THE CMN STE 4
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4583
Practice Address - Country:US
Practice Address - Phone:201-320-5841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist