Provider Demographics
NPI:1669146353
Name:FERNANDEZ, ARACELI (LCSW)
Entity type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 STATE ROUTE 18 BUILDING A, SUITE 105
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3722
Mailing Address - Country:US
Mailing Address - Phone:732-705-6552
Mailing Address - Fax:
Practice Address - Street 1:646 STATE ROUTE 18 STE 206
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3722
Practice Address - Country:US
Practice Address - Phone:646-385-1957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06498600104100000X
NJ44SC061269001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker