Provider Demographics
NPI:1700997814
Name:CESARE, DENNIS A (MA, LPC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:A
Last Name:CESARE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 N. WALNUT AVENUE
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:NJ
Mailing Address - Zip Code:08049
Mailing Address - Country:US
Mailing Address - Phone:856-434-1364
Mailing Address - Fax:856-322-1282
Practice Address - Street 1:117 NORTH BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:RUNNEMEDE
Practice Address - State:NJ
Practice Address - Zip Code:08078
Practice Address - Country:US
Practice Address - Phone:856-434-1364
Practice Address - Fax:856-322-1282
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00139800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7694527OtherAETNA
PA2322022000OtherIBC
PA568232000OtherKEYSTONE