Provider Demographics
NPI:1700530094
Name:EVERETT, JOSEPH (LSW, MSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:EVERETT
Suffix:
Gender:M
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ANDOVER PL
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3403
Mailing Address - Country:US
Mailing Address - Phone:201-873-7071
Mailing Address - Fax:
Practice Address - Street 1:18 ANDOVER PL
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-3403
Practice Address - Country:US
Practice Address - Phone:201-873-7071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06707200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker